Antiphospholipid Syndrome & Pregnancy Loss: A Personal Story

Question
I had a daughter in 2000, only complications being toxemia.  I then got pregnant in 2004 that ended in miscarriage at 10 wks.  Again, another miscarriage at 5wks in 2007.  We then went to see a fertility specialist and was diagnosed with antiphospholipid antibody syndrome.  I once again got pregnant and was put on 40mg of Lovenox once daily.  Everything appeared to be going fine until at a routine 36wk check-up, no heart beat was found, resulting in a stillborn girl.  I am currently on coumadin for 6 months due to having c-section.  When I do get pregnant again, I am scared to have this happen again.  We have been told to have baby delivered at 32-34 wks both answers coming from different dr's.  Also, my obgyn says he will increase lovenox to 60mg twice daily.  The fertility specialist says 40mg once daily should get you through the entire pregnancy.  However when I was taking the 40mg once daily, very small blood clots were found in placenta, and dr's are assuming one lodged in umbilical cord.  That makes me think that 40mg is not enough.  Also, is it better to use lovenox or heparin?  Is there a difference?  Thank you for your time, we are trying to educate ourself as much as possible before getting pregnant again to give us the best chance possible at a healty baby.  Thank you, Amy

Answer
Dear Amy

I am sorry for the disappointments you had. I certainly do agree with the 2 doctors who advised delivery at 32-34 weeks. In fact, I may go even earlier if there is any evidence of placental insufficiency arised ant time during pregnancy and therefore, I also advise twice/week non stress testing and/or biophysical profile assessment starting from the 28th weeks of pregnancy. An adequate neonatal intensive care facilities should be present in any hospital you decide to deliver in, especially with a preterm delivery.

Unfortunately, lovenox is not available in my countr, or may be available under a different name, and therefore i cannot answer your question about the difference between it and heparin.

I wish u well in your coming pregnany and feel free to send me back if u ever need help.