Which of the following is recommended in a woman with Antiphospholipid Antibodies and history of prior aboions / still bih.
Answer is B (Aspirin + Low molecular weight Heparin): The recommended treatment for women with recurrent pregnancy loss associated with antiphospholipid syndrome includes combined Aspirin and Heparin therapy. 'In pregnant SLE patients with Antiphospholipid antibodies and prior fetal loss, treatment with heparin (standard or low -molecular- weight) plus low dose aspirin has been shown in prospective controlled trials to increase significantly the propoion of live bihs'. - Harrison's 17th/2082 'Combined aspirin and heparin therapy has proven effectiveness and is the preferred treatment for women with recurrent pregnancy loss associated with antiphospholipid syndrome' - Speroff 7th/1084 Antiphospholipid syndrome in pregnancy The risk of pregnancy loss in women with APS and prior pregnancy loss may exceed 60% History of recurrent fetal loss in a pregnant woman with Antiphospholipid antibodies is an indication of treatment during pregnancy as these are identifiable and treatable immunologic disorders Treatment options include Antiplatelet agents such as Aspirin, Anticoagulants such as Heparin / LMWH, and coicosteroids Aspirin along with Heparin / LMWH is the recommended treatment of choice. Coicosteroids should be avoided ifpossible. If required to control maternal SLE, these should be used at the lowest effective doses for the shoest time required.
Aspirin only
Aspirin + Low molecular weight Heparin
Aspirin + Low molecular weight Heparin + Prednisolone
No Treatment