APA's, Hashimoto's Thyroiditis & 5 Weeks Pregnant

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History: July 1996 M/C blighted ovum at 7 1/2 No spotting, missed m/c & D&C. Had prolonged bleeding post D&C treated with methergine.

Healthy son born 7/2/97 -- has some spotting at 7-8 weeks, brown blood. Otherwise pregnancy was healthy. Prolonged labor & postpartum hemmorrhage.

D&E at 14.2 weeks 5/21/99 due to Trisomy 18; red spotting at 7-8 weeks and 10 1/2 -14 weeks until D&E.

TTC since August 99; Diagnosed by primary care with Hashi's Thyroiditis [had pronounced goiter] in early Nov. Started on 50 mcg of levoxyl & referred to RE for Dec. evaluation.

Although warned to use birth control during Dec's eval. cycle did not listen and became pregnant. Meanwhile TSH has dropped from 17.7 to 4.57 and T4 now in low normal range.

Yesterday I was exactly 5 weeks pregnant on 28 day cycle. With positive pregnancy test I was put on crinone 8% -- my progesterone level was 32 at 12 DPO. I was called this Thursday [2 days short of 5 weeks] with news that I am moderately positive with APA [no additional details] and should start 81mg of baby aspirin which I did. My HcG levels are: 12 DPO 103 14 DPO 307 21 DPO 6030 Progesterone 34.7 I have been told to return at 6 weeks for doctor u/s and more blood draws. I also have a mini-consult [really scheduled for the results of the fertility testing that I am keeping for Tuesday.

Obviously I am very very concerned that I did not start baby aspirin before conception. Also when is heparin indicated? I also think I remember reading on Dr. Beer's site that 75% [?] of patients with elevated APA's lose their pregnancies if not started on baby aspirin and heparin prior to conception. So are my chances now of carrying baby to term as low as 25%? BTW I had some slight brown spotting which presented itself the following morning after starting crinone. This has almost disappeared.

Worried & Sad in Boston, Ann-Marie

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