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Dr. please need opinion: do I need heparin/aspirin?From: Ann (anonymous@obgyn.net)Wed, 10 Jul 2002 12:34:24 -0500 (CDT)
Hello Dr. and thank you for the time and effort you dedicate to this bord! I have recently had a miscarriage (my first) at 16 weeks - pg. after 4 years of trying and infertility treatments (for male factor). It was a placental abruption; the baby apeared healthy, had grown well for the age, normal cromozomes. The only other thing the pathology report said was that the cord was velamentously inserted. Other relevant things - had a subchorionic bleed since beginning of pgcy and was put on bed rest/reduced activity since 4 weeks. Also, before being pg. I had a inconclusive (not positive) anticardiolipin antibodies test - the Igm only was 12 (normal was less than 12)- all the other tests (ANA, APA, Igg and Iga of ACA, ATA) were normal. I was on baby aspirin due to the ACA. I recently saw an MFM specialist and she ordered a complete thrombophilia work up and repeat antibodies tests. But surprisingly, she said that even if all tests come back normal, she recomends starting on LMW heparin with the next pregnancy, just based on the poor history! I do not have the results yet but would you put a patient on heparin for a previous miscarriage and an inconclusive ACA in the past? Is this overkill? But of course, I would not want to find out via another loss that I needed it... Thanks for your reply! Ann
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