Medical Questions > Conditions and Diseases > Lupus Forum

Baby aspirin during pregnancy ?

User Profile
Hi All

I am 14 weeks pregnant and my rheumatologist and obstetrician have recommended me to have baby aspirin (75mg)+heparin for prevention, or at least aspirin. I had one miscarriage in 2009. I am anti-Ro and anti -La positive , and recently they told me me I am borderline anticardiolipin (normal levels are 9.8 and i am 10, so this may vary depending on the lab).

I do not have any Lupus symptoms for the last 3 years, and I am not on any medication. I have read that for women with strong flares and high levels of anti-cardiolipin antibodies, and multiple miscarriages, the treatment with aspirin+heparin can reduce the risk of miscarriage by 40%, and it seems is much more effective asp+hep than just aspirin.

I am a bit worried about having aspirin during pregnancy, although 75mg dosis are supposed to be safe. I am not sure because my anti-cardiolipin antibodies levels are low and because I do not have lupus symptoms at the moment, and it seems to me there is no evidence


Did you find this post helpful?
|

User Profile
replied March 12th, 2010
Lupus Answer A10638
Hi, welcome to the ehealth forum and I am glad to help you.
You seem concerned by the history of one miscarriage and borderline anticardiolipin antibodies with diagnosis of Lupus and positive anti-Ro and anti-La antibodies. You are unsure about whether to start aspirin + heparin which is known to reduce the risk of miscarriage.
You seem to have been suggested the diagnosis of secondary antiphospholipid syndrome(APS) which has a risk of recurrent miscarriages. The reason for this is unclear; some researchers believe that antiphospholipid syndrome causes tiny blood clots to block the blood supply to the placenta. Others believe that having antiphospholipid syndrome may interfere with the fertilized egg’s ability to implant in the lining of the uterus. Most people who have antiphospholipid antibodies have no symptoms, though the disorder can cause blood clots and other health problems in some people. For women, recurrent miscarriages may be the only symptom of the disorder. Generally, when considering antiphospholipid syndrome as a possible factor in recurrent miscarriages, doctors look for a person to be positive for lupus anticoagulant antibodies or anticardiolipin antibodies on more than one occasion before making a diagnosis. In your case if the diagnosis is being considered fresh, repeat test can be done for anticardiolipin antibodies to confirm the diagnosis. But it seems that you have a strong case to start the therapy( low-dose aspirin and/or heparin injections) because of past history of miscarriage though you are not having any flare up of lupus. Although this treatment improves pregnancy outcomes for women with antiphospholipid syndrome, these therapies can increase the rates of third-trimester pregnancy complications, however, so women with antiphospholipid syndrome usually need to see a high-risk specialist and have regular prenatal care during pregnancy. Low molecular weight heparin is quite safe in pregnancy with few side effects and it does not cross the placenta. The risk of abruptio placentae is there with aspirin and dose related and rarely seen with baby aspirin so low dose aspirin is relatively safe in pregnancy.
Hope this helps. Take care.
Note: This post is not to emphasise final diagnosis as the same cannot be made online and is aimed just to provide medical information and no treatment suggested above be taken without face to face consultation with health care professional.



|
Did you find this post helpful?

User Profile
replied March 13th, 2010
Thanks a lot for your response Dr. Harpreet. I I think I will probably ask my rheumatologists for a second ACL test just to confirm, since 6 months ago I was ACL negative. And as far as I know is normal practice to have 2 test with 6 weeks separation before making a diagnosis of anti-phospolipid syndrome. They did not offer me a second test, but directly to start on aspirin and/or heparin, so I will ask my Rheuma NHS doctor to carry out a second test, and then if it comes positive again I will start on aspirin. I am not sure why they don't offer you a second test before putting you on medication. The only thing is that first I have to get an appointment, plus the test takes a while, so probably I will not be able to start on aspirin, if needed, till week 16-17, hopefully not too late. My previous email was cut at the end, it was in relaxion with hydroxicloroquine, would I be able to breast feed if i have to be on it during pregnancy and is it safe while breast feeding?, I have found some contradictory information in this regard. Thanks again for your help, very helpful indeed.
|
Did you find this post helpful?

User Profile
replied March 13th, 2010
Thanks a lot for your response Dr. Harpreet. I I think I will probably ask my rheumatologists for a second ACL test just to confirm, since 6 months ago I was ACL negative. And as far as I know is normal practice to have 2 test with 6 weeks separation before making a diagnosis of anti-phospolipid syndrome. They did not offer me a second test, but directly to start on aspirin and/or heparin, so I will ask my Rheuma NHS doctor to carry out a second test, and then if it comes positive again I will start on aspirin. I am not sure why they don't offer you a second test before putting you on medication. The only thing is that first I have to get an appointment, plus the test takes a while, so probably I will not be able to start on aspirin, if needed, till week 16-17, hopefully not too late. My previous email was cut at the end, it was in relaxion with hydroxicloroquine, would I be able to breast feed if i have to be on it during pregnancy and is it safe while breast feeding?, I have found some contradictory information in this regard. Thanks again for your help, very helpful indeed.
|
Did you find this post helpful?

User Profile
replied March 13th, 2010
Thanks a lot for your response Dr. Harpreet. I I think I will probably ask my rheumatologists for a second ACL test just to confirm, since 6 months ago I was ACL negative. And as far as I know is normal practice to have 2 test with 6 weeks separation before making a diagnosis of anti-phospolipid syndrome. They did not offer me a second test, but directly to start on aspirin and/or heparin, so I will ask my Rheuma NHS doctor to carry out a second test, and then if it comes positive again I will start on aspirin. I am not sure why they don't offer you a second test before putting you on medication. The only thing is that first I have to get an appointment, plus the test takes a while, so probably I will not be able to start on aspirin, if needed, till week 16-17, hopefully not too late. My previous email was cut at the end, it was in relaxion with hydroxicloroquine, would I be able to breast feed if i have to be on it during pregnancy and is it safe while breast feeding?, I have found some contradictory information in this regard. Thanks again for your help, very helpful indeed.
|
Did you find this post helpful?
Must Read
Learn the basics about autoimmune disorders, including risk factors, diagnosis, and treatment options. ...
Learn about risk factors to developing an autoimmune disorder. ...
Learn about screening and diagnosis options available for autoimmune disorders....
DISCLAIMER: "Ask a Doctor" questions are answered by certified physicians and other medical professionals. For more information about experts participating in the "Ask a Doctor" Network, please visit our medical experts page. You may also visit our Lupus , for moderated patient to patient support and information.

The information provided on eHealth Forum is designed to improve, not replace, the relationship between a patient and his/her own physician. Personal consultation(s) with a qualified medical professional is the proper means for diagnosing any medical condition.