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Thread: anti-cardiolipin antibodies

  1. #1
    Join Date
    Oct 2010
    Posts
    7

    Default anti-cardiolipin antibodies (preg and m/c mentioned)

    I am a single woman trying to conceive by donor insemination. I got pregnant with my first IUI, with a pregnancy that started out textbook perfect- high betas, good progesterone levels. We saw the heartbeat at 6.5 and 7.5 weeks but I noticed the growth (measured by crown rump length) was starting to slow a bit by 7.5 weeks. I went back for my 12 week ultrasound to find my baby was dead and had shrunk in size from the last 7.5 week ultrasound. Tests of the fetus revealed a normal XY karyotype.

    My RE tested me only for anti thyroid peroxidase antibodies, Lupus anti-coagulant and cardiolipin antibodies. anti TPO were positive (107 with a TSH of 2.86). I started synthyroid (50 mcg/day)

    DRVVT results : drvvt patient 33.2 control 30.9 ratio 1.07

    Cardiolipin IgG was 22 and IgM was 1.

    The IgG value is so confusing- I cannot tell if its a source for worry or not. The ranges for this lab puts a value of 21-80 in the 'moderately elevated' category, so it has been flagged.

    I'm now pregnant again (almost 5 weeks along) with my second IUI. I'm really concerned about my anti-cardiolipin Ig levels and how to treat it. My RE waved it off as requiring no treatment, but my perinatologist said if it comes back at a similar value, we will start me on baby aspirin. Another doctor recommended heparin. Nobody can reach a consensus, apparently.

    Off topic a bit, but I checked my CBC/chem panel my mean platelet volume is just below the lower limit of normalcy. I have to wonder if this would this make me a worse candidate for heparin than the average person- can you comment?

    My principal question is this- if the cardiolipin ab retest (5-6 weeks after original) comes back at a similar level- what would you advice?

  2. #2
    Join Date
    Sep 2008
    Posts
    677

    Default

    Without having benefit of complete consulation and evaluation of your particular situation, it is difficult for me to give advice regarding specific treatment, In general we would treat positive APA during pregnancy with heparin and aspirin. Dr. Coulam

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