title: First-trimester low-dose prednisolone in refractory antiphospholipid antibody-related pregnancy loss.
abstract: The objective of this study was to assess pregnancy outcome in women with a history of refractory antiphospholipid antibody-associated pregnancy loss(es) who were treated with early low-dose prednisolone in addition to aspirin and heparin. Eighteen women with antiphospholipid antibodies who had refractory pregnancy loss(es) were given prednisolone (10 mg) from the time of their positive pregnancy test to 14 weeks' gestation. Before low-dose prednisolone was given as treatment, 4 (4%) of 97 pregnancies had resulted in live births. Among 23 pregnancies supplemented with prednisolone, 9 women had 14 live births (61%), including 8 uncomplicated pregnancies. The remainder were complicated by preterm delivery, preeclampsia, and/or small-for-gestational-age infants. There were 8 first-trimester miscarriages and 1 ectopic pregnancy. There were no fetal deaths after 10 weeks' gestation and no evidence of maternal morbidity. The addition of first-trimester low-dose prednisolone to conventional treatment is worthy of further assessment in the management of refractory antiphospholipid antibody-related pregnancy loss(es), although complications remain elevated.
authors.affiliation: Maternal and Fetal Research Unit, King's College London, London, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Bramham
authors.forename: Mari
authors.initials: M
authors.lastname: Thomas
authors.forename: Catherine
authors.initials: C
authors.lastname: Nelson-Piercy
authors.forename: Munther
authors.initials: M
authors.lastname: Khamashta
authors.forename: Beverley J
authors.initials: BJ
authors.lastname: Hunt
mesh_terms: D000022:Abortion, Spontaneous / Q000188:drug therapy* / Q000276:immunology; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D017152:Antibodies, Antiphospholipid / Q000009:adverse effects* / Q000276:immunology; D000925:Anticoagulants / Q000627:therapeutic use*; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000188:drug therapy; D001241:Aspirin / Q000627:therapeutic use*; D005260:Female; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D011239:Prednisolone / Q000627:therapeutic use*; D011247:Pregnancy; D011261:Pregnancy Trimester, First
chemical_list: D000893:Anti-Inflammatory Agents; D017152:Antibodies, Antiphospholipid; D000925:Anticoagulants; D006493:Heparin; D011239:Prednisolone; D001241:Aspirin