pregancy and APS?

Question

I have APS (antiphospholipid antibody syndrome) was diagnosed when pregant with my daughter thankfully with treatment she was born perfectly healthy. My ob at the time made it sound like I shouldnt have more kids but I have been reading on the web and there is no sites out there that are giving me the same information that she did. So what I want to know is there anyone out there that has aps and has had more than one child? I really want more but unsure about how safe it would be.

Answer 1

The diagnosis of APS is very difficult, and also controversial among doctors.

There are 3 blood tests that are commonly used, and accepted by most physicians.

As many as 15 blood tests for antiphospholipids are available; however, there is little evidence that patients who are positive by the "extra" blood tests are at increased risk for pregnancy problems.

The problem is that 2% of all pregnant women have positive blood tests. Most of these women never have problems with abnormal pregnancy outcomes and treating them would expose them to the side effects of the treatment without benefit.

Therefore, diagnosis involves more than blood tests.

There must be "clinical signs" medical problems that have already occurred in addition to the abnormal blood tests.

The clinical signs are a history of blood clots in a large vein or in an artery, three or more consecutive miscarriages, low platelet count, anemia caused by blood being broken down in the blood stream, stroke, and still birth.

The levels of antibody can go up and down, and even disappear, so to definitely say someone has APS, the blood tests need to repeated at least 8 weeks from the first and still be positive. The decision on treatment at a particular time (such as pregnancy) depends upon the levels and what the previous medical problems were.



Disease Impact on Pregnancy

The manifestations of APS are variable. Most people will not have more than one of these problems.

Recurring miscarriage

Preeclampsia

Insufficient function of the placenta causing poor growth of the baby and/or inability of the baby to tolerate labor

Blood clot in an artery or large vein either during the pregnancy, or up to six weeks after the baby is born

Stillbirth

A very rare APS condition exists of a severe postpartum illness with fever and heart, lung and kidney failure and multiple blood clots.



Pregnancy Impact on Disease

Patients with APS are more prone to blood clots during pregnancy and up to 6 weeks after pregnancy. The blood clots may migrate to the lungs which is a very serious and life threatening event.


Special Prenatal/Birth/Neonatal Considerations

Ideally, one should seek medical advice before becoming pregnant. When you get pregnant it is important to be referred to your Obstetrician as early as possible to decide on the need for treatment with aspirin or heparin.

Once pregnancy is achieved, frequent office visits will be needed to:

Screen for preeclampsia,

Monitor the fetus with either nonstress test or biophysical profile

Ultrasound examinations every 3-4 weeks to check the growth of the baby.

For patients on heparin, extra blood tests may be needed to adjust the dose depending on the type of heparin being used, and the past history of the patient.

Patients on low molecular weight heparin may not be able to have epidural or spinal anesthesia.



Treatment of APS During Pregnancy

Treatment of APS during pregnancy involves low dose aspirin and/or heparin

1 baby aspirin (80 mg)/day is usually started as soon as pregnancy is diagnosed

Heparin injections are usually started at 8 weeks. Not all patients with APS need heparin.

Heparin is a blood thinner. It can only be given by injection. The needle is very thin, and is put just under the skin. Most patients can do this by themselves.

The effects of heparin depend on the dose given

In "therapeutic doses" the blood does not clot, and women will bruise and bleed easily.

In "prophylactic doses", the blood clots normally and there is just bruising at the site of injection.

The dose used depends on the clinical problems from APS.

There are 2 types of heparin

Low molecular weight heparin

Is given once or twice a day.

It is almost 10 times as expensive as regular heparin.

It lasts longer than regular heparin so epidural anesthesia cannot be used unless 24 hours has elapsed since the last injection.

Unfractionated or regular heparin

It is given 2 – 3 times a day.

It costs much less than low molecular weight heparin.

It has a higher chance of causing low platelets as a side effect than does low molecular weight heparin.

If only "prophylactic" doses are used, there is no problem with epidural anesthesia.

Answer 2

none. not anything is one hundred% being pregnant evidence. except you may have a hysterectomy then there is not any strategy to be one hundred% certain. condoms will aid within the prevention of being pregnant however you're higher off going at the capsule and dressed in condoms.

Answer 3

I suggest getting a second opinion from another OB/GYN.