LOW-DOSE ASPIRIN FOR PREVENTION OF PREGNANCY LOSSES IN WOMEN WITH PRIMARY ANTIPHOSPHOLIPID SYNDROME

Pregnancy loss, often recurrent, is one of the most important clinical manifestations associated with the primary antiphospholipid syndrome. In these cases, pregnancy wastage is related to the presence of antip hospholipid antibodies, namely lupus anticoagulant and anticardiolipin antibodies, but patients do not have features of systemic lupus eryth ematosus or any other well-defined autoimmune disease. We report here on the outcome of 21 consecutive pregnancies in 18 patients with the s yndrome who were treated with low-dose aspirin (100 mg/day) from 1 mon th before attempting conception and throughout the pregnancy. Low-dose prednisone (15-30 mg/day) was added for potentially non-obstetric (au toimmune-related) reasons in six pregnancies. Patients were monitored as having high-risk pregnancies. Prior to therapy, the rate of live-bo rn babies was 6.1% (46 previous fetal losses and three live-born babie s), and after therapy, it was 90.5% (21 pregnancies and 19 live-born b abies). Pre-term delivery due to maternal or fetal indications was req uired in 15% (3/20) of the viable pregnancies. Except for prematurity (20% of viable pregnancies) and its potential associated complications , there were no significant adverse effects to either mothers or babie s. Our treatment modality is advocated for prevention of pregnancy los ses in patients with the 'obstetric' primary antiphospholipid syndrome .