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Are there oral-coagulants available for APLA and will it cause risk to the baby?

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Posted on Sat, 4 Jan 2014
Question: Hello, I had a missed abortion last week at 9 weeks gestation. Initial blood work has come out positive for Anticardiolipin antibody IgG and IgM at 61 (GPL) and 20 (MPL) resp. also AntiBetaA2Glycoprotein IgG and IgM is positive with values of 35 (GPL) and 23 (MPL). Comment is APLA positive. After showing the report to my gynaec i am told that in my next pregnancy i will have to take anticoagulant injections everyday for the entire pregnancy period. I have follwoing questions : Are there oral-coagulants available which can be taken instead of injections ? Will it have any side effects on my baby in short and long term? will i be able to conceive normally with this condition present in my body ? also apart from fetal loss does this condition have any other effects on the health of person in the long run ? Is this a rare condition or fairly common among today's women ? I have attached scanned copies of report with the query. I am very disturbed and would appreciate honest answers to my queries raised Regards, XXXXXXX
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Answered by Dr. Rhea Chanda (38 minutes later)
Brief Answer: apla is common Detailed Answer: Hello XXXXXXX Firstly i need to comment that APLA is common cause of recurrent pregnancy loss . The problem here is not conception . But retaining the pregnancy . That's why there may be recurrent pregnancy losses . It's not harmful per say to your health but to your pregnancy . Anti coagulants are given to the patients to help increase blood circulation to the fetus . I'm sorry but oral anti coagulants are contra indicated in pregnancy. It will have to be injections . Conception shouldn't be a problem here. Anti coagulants are given upto few weeks before term . It won't harm the baby . Hope i could answer some questions . Get back to me if you have more .
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Rhea Chanda (36 minutes later)
Hello doctor thanks for your reply, feel better after reading it. The reason i asked about effects on health apart from pregnancy is i read somewhere that many health problems, such as stroke, heart attack, kidney damage, deep vein thrombosis , pulmonary embolism can happen because of APS syndrome, post pregnancy what care should i take ? And are these anticoagulant injections intramuscular or intravenous,(given on arm or buttock ?) i dont remember the name of the injection which the doctor mentioned. Based on your experience have you seen 100% success with this line of treatment ? and how do we know the treatment (taking injections daily) is working, what tests have to be conducted and how frequently ? I was taking ecospirin when i was pregnant , this was prescribed by doctor since i have had problem of endometrium being thin, will this be continued as well along with injections. I know i have been asking a lot of questions ! thought becoming a mother was not so complicated!
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Answered by Dr. Rhea Chanda (31 minutes later)
Brief Answer: rare complications Detailed Answer: The complications you have mentioned are extreme and usually occur if there is any underlying condition of morbidity . They dont occur on a regular basis . I should mention that nothing is 100% successful . All we can do is try and hope for a .success ful outcome . These injections can be given either way but mostly they are given im . Buttocks are better than the arm since regular injections are needed. Certain blood tests will be done every few months to check the levels along with routine blood tests and ultrasound . Normally we dont combine oral and injections . Your doctor will probably switch you to injectables after you are pregnant .
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Rhea Chanda

OBGYN

Practicing since :2005

Answered : 3161 Questions

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Are there oral-coagulants available for APLA and will it cause risk to the baby?

Brief Answer: apla is common Detailed Answer: Hello XXXXXXX Firstly i need to comment that APLA is common cause of recurrent pregnancy loss . The problem here is not conception . But retaining the pregnancy . That's why there may be recurrent pregnancy losses . It's not harmful per say to your health but to your pregnancy . Anti coagulants are given to the patients to help increase blood circulation to the fetus . I'm sorry but oral anti coagulants are contra indicated in pregnancy. It will have to be injections . Conception shouldn't be a problem here. Anti coagulants are given upto few weeks before term . It won't harm the baby . Hope i could answer some questions . Get back to me if you have more .