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Re: Antiphospholipid Syndrome? From: Danny Tucker (obgylist@obsdoc.demon.co.uk) Fri Dec 29 01:02:54 1995 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Danny Tucker: "Re: HELLP & steroids" Previous message: Gary Kaufman: "Antiphospholipid Syndrome?" Maybe in reply to: Gary Kaufman: "Antiphospholipid Syndrome?" Next in thread: dahmd@gate.net: "Re: Antiphospholipid Syndrome?" Gary Kaufman MD, >>I just met a patient with a 16 week IUP and a moderate sized right sided DVT on doppler. Interestingly, she's had two prior losses, including a second trimester fetal demise. On admission (and before heparin was started) her platlet count was 60 and PTT normal. In her old chart is an anticardiolipin done in 7/94 at Igg 32.5 gpl (< 23 normal). >>Given the positive ACL, fetal losses, thrombocytopenia and thrombosis it seems like antiphospholipid sydrome is a safe bet. >>Recommendations regarding long term therapy - >>SQ heparin at 12,000 units bid? >>Role of low molecular weight heparin, prednisone, asa? In view of the previous loss & positive Ab's, the chance of fetal loss is pretty high for this woman, isn't it. There is a sparcity of RCT's for this condition in the literature, the only one being: Cowchock S, Reece EA, Balaban D et al 1992 Repeated fetal losses associated with antiphospholipid antibodies: a collaborative randomised trial comparing prednisolone with low dose heparin treatment. Am J Obstet Gynecol 166: 1318-1323 Only 20 subjects and no placebo. No difference in livebirth rate, although the steroid group had a higher incidence of PROM. Low dose aspirin plus heparin? --------------------------------------------------------------------------- Danny Tucker --------------------------------------------------------------------------- Senior House Officer -- --------------------------------------------------------------------------- Obstetrics & Gynaecology Nottingham, UK E-mail: dtucker@obsdoc.demon.co.uk --------------------------------------------------------------------------- Next message: Danny Tucker: "Re: HELLP & steroids" Previous message: Gary Kaufman: "Antiphospholipid Syndrome?" Maybe in reply to: Gary Kaufman: "Antiphospholipid Syndrome?" Next in thread: dahmd@gate.net: "Re: Antiphospholipid Syndrome?"

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