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Re: Antiphospholipid Syndrome?From: dahmd@gate.netFri Dec 29 06:05:12 1995
Regarding antiphospholipid antibody syndrome: I have seen a number of people with fetal losses and antiphospholipid antibodies, or a positive lupus anticoagulant. The perinatologists I speak with all seem to be going to aspirin plus heparin. Some say "full dose" anticoagulation with the goal of the PTT being 1.5 or so times normal, while others think that 5000 to 7500 units BID is adequate. Prednisone is out of the picture around these parts. I am curious what the perinatologists on our list think about the treatment of this condition. I once cared for a patient with 7 fetal losses between 16 and 23 weeks, and no live births. She told me it was due to her "chronic syphilis" that her ex-husband gave her. She described how she and he were virgins when they married, but since he gave her "chronic syphilis" he must have been lying about his sexual experience. It seems no doctor has ever been able to cure her of her "low-grade" syphilis, despite gallons of penicillin. Of course, the lupus anticoagulant was positive, while the FTA was not. Her realization that the poor guy was telling the truth seemed tempered by the rather hefty alimony payments. We sure practice in an interesting specialty! (She delivered at 38 weeks of a healthy girl, after 7500 units Bid heparin and a 1/2 baby aspirin twice a day). Ashley Hill dahmd@gate.net
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