Lupus anticoagulant. Significance in habitual first-trimester abortion.
Therapy with steroids and aspirin has been reported to benefit pregnancies in patients with lupus anticoagulant (LA). In this study, habitual first-trimester aborters with LA using steroids and aspirin were compared to a control group of untreated habitual aborters without LA. In habitual aborters with LA, 12 of 24 (50%) pregnancies reached the second trimester as compared to 8 of 22 pregnancies (36%) in the control group. Since the treated group did no better than the control group, LA probably is not a cause of first-trimester abortion. However, once the second trimester is reached, a 50% incidence of growth retardation was found, and 42% of fetuses died in the second or third trimester in treated LA patients. Treatment with steroids and anti-platelet aggregating agents may be necessary despite the attendant risks to prevent those sequelae in the second and third trimesters. There was a 29% live birth rate in treated LA patients; the rate was 36% in control patients. However, this rate was produced only by early intervention, which was unnecessary in the control patients.
Carp
H J
HJ
Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Menashe
Y
Y
Frenkel
Y
Y
Many
A
A
Nebel
L
L
Toder
V
V
Mashiach
S
S
D000026:Abortion, Habitual / Q000097:blood* / Q000517:prevention & control; D000328:Adult; D001241:Aspirin / Q000627:therapeutic use; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D005317:Fetal Growth Retardation / Q000453:epidemiology; D006801:Humans; D016682:Lupus Coagulation Inhibitor / Q000097:blood*; D011241:Prednisone / Q000627:therapeutic use; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood
D016682:Lupus Coagulation Inhibitor; D001241:Aspirin; D011241:Prednisone