Antiphospholipid Antibodies in pregnancy

[Melody2]

Hi!

I just had a quick question to ask all of you ladies out there with APS or positive anticardiolipin or lupus anticoagulant...I know this condition can make one more inclined to clot. My GP tells me this isn't something to worry about with regards to conceiving a child and that I don't need to see anyone prior to trying to conceive. However, I do have a question...have any of you heard the flip side of this? My understanding is that in a small percentage of women with this condition the problem isn't with clots forming, but rather hemorhagging during childbirth. I wonder as in the past I have had some menstrual cycles that have been basically hemorhagging, and was concerned that I may be susceptible to this. I know the most common thing is to suffer from miscarriages, etc...that the main concern is to prevent clotting...is anyone aware of this other side or experienced it? I wish my doctor had more information, and my specialist is on medical leave and is not planning to return, so I don't really have anyone I can trust to ask this question. Naturally, I will investigate further, but I thought a good place to start was here to see if anyone had heard of this. My GP doesn't seem to think it's necessary for me to speak to anyone prior to trying to conceive, but to go ahead and conceive and then manage it as we go. That has left me feeling rather uneasy, as I want to be sure of my safety and the safety of my child before pursuing this.

Take care, I hope you are doing well as can be.
Melody style_emoticons/<#EMO_DIR#>/clover.gif

[alobreto]

Hi, Melody! style_emoticons/<#EMO_DIR#>/smile.gif
I agree with you that it's wiser to wait and be sure to do the very best you can for you and baby, even before conception. I'd be uncomfortable, too, I think if I were given the go-ahead without clear information on a particular known health condition.

I know very little about APS, but I do know that it is treated with anticoagulant meds and that before conception and during pregnancy there are limited options of what meds can be safely used. For that reason alone, I think you're being prudent to wait until your specialist is back.

Because meds that cause delayed blood clotting are used for the condition, I wonder if this is what you've heard about as far as excessive bleeding at time of delivery. Because of necessary treatment, it seems likely that one would be more prone to a degree of greater blood loss during delivery. That is just my supposition, though. As I said, I really don't know a lot about it.

I hope your consultant gets back soon and gives you some more thorough answers.
Best regards,
Angela style_emoticons/<#EMO_DIR#>/flowers.gif

[cath]

Melody,

Hi and all the best with your plans. I agree - a pre conception chat is a good idea.

I can think of two theoretical scenarios where APS MIGHT lead to increased bleeding, but how much this actually happens in practice I don't know.

1. If there is a lot of clotting going on in the body, the platelets can get ''?sed up", which might lead to increased bleeding. One of the effects of lupus and APS can be reduced platelets. Usually this isn't a problem unless they fall below 100 (over 150 is normal, so there is a wide safety margin).

2. Prophylaxis for APS eg heparin and asprin in pregnancy, and warfarin at other times will increase clotting time and therefore increase the risk of bleeding. In this case it isn't the APS itself, but the effect of the drugs to treat it being too effective.

I hope your doc can give you some helpful advice! style_emoticons/<#EMO_DIR#>/goodvibes.gif

X C X

[Melody2]

Thanks so much for your replies Alobreto and Cath, some very good insight as to what may cause the bleeding scenario. I hadn't even considered that it may not be the condition itself but the meds used to treat the condition, and I do have lower WBC, so hadn't considered the platelets possibly being used up....those are helpful thoughts. I will definitely wait until I have spoken to someone more familiar with this condition before going ahead...I think my GP was being a bit too laid back about just go ahead and get pregnant then treat it as it goes, but he's always been that way. Unfortunately my specialist looks like she won't be returning at all, so I'll have to try and find another one that I can trust...my old one was top of her field, so it will be hard replacing her. But my hubby and I really do want to conceive, so thank-you for your imput...it gives me some more ideas to discuss with my doctor and helps me feel better informed about this possible scenario.

Thank- you so much!


Take care,
Melody style_emoticons/<#EMO_DIR#>/clover.gif