Lupus Anticoagulant Antibodies and Repeated Miscarriage

When you experience recurring miscarriages, your doctor will likely run tests to determine why. If lupus anticoagulant antibodies are found during the course of your doctor's investigation, it's important to understand what effect this diagnosis will have on a pregnancy and what role these antibodies played in a previous miscarriages.

Better your understanding of this diagnosis with this review, which includes the risks and possible treatments for this condition.

Effect of Lupus Anticoagulant on Pregnancy

Lupus anticoagulant antibodies are one of the markers for antiphospholipid syndrome, a disorder in which the body creates antibodies against phospholipids (a normal component of human blood cells). Accordingly, lupus anticoagulant and other antiphospholipid antibodies can cause tiny blood clots that can lead to pregnancy complications, including miscarriage.

Although a person will usually show no symptoms of having lupus anticoagulant antibodies, pregnancy complications might be the first sign of antiphospholipid syndrome. People can however have non-obstetric complications prior to that.

About half of people with lupus have antiphospholipid antibodies, but you do not have to have lupus for your body to produce lupus anticoagulant antibodies. In addition to miscarriage, these types of antibodies can cause a myriad of issues including stroke, pulmonary emboli, and cardiovascular problems.

Testing for Lupus Anticoagulant Antibodies

If you have a history of recurrent pregnancy losses or a previous health history that suggests antiphospholipid syndrome, your doctor may order one or more of the following laboratory coagulation tests:

• Activated partial thromboplastin time (aPTT)
• Dilute or modified Russell's viper venom test (dRVVT or MRVVT)
• Prothrombin time (PT)
• Kaolin plasma clotting time (KCT)

Each of these tests examines the clotting time of a person's blood to determine if it is within normal range. If tests return with abnormal values, your doctor may order follow-up tests to confirm the abnormalities and be sure that the unusual results were not due to lab contamination or other clotting abnormalities.

Miscarriage and Lupus Anticoagulant

Miscarriage is a devastating occurrence wrought with emotional and physical consequences. Many people who experience miscarriage repeatedly want answers as to why they've experienced recurrent pregnancy loss.

Because lupus anticoagulant is a known risk factor for recurrent miscarriages, your physician will likely test for the presence of these antibodies when investigating the cause of subsequent fetal losses.

Recurrent miscarriages impact approximately 1% of the population, and in 10-15% of cases, antiphospholipid syndrome is found to be the cause. Although antiphospholipid syndrome can cause early gestation miscarriages (less than 10 weeks), it is also a cause of late miscarriage, stillbirth, and other pregnancy complications.

Once you know that you have lupus anticoagulant antibodies, it is important to understand that it is still possible to carry a baby to term. Your doctor will be able to recommend specific treatment options that may be available to you, as well as test for any other medical conditions that will make it difficult for you to have a successful pregnancy.

Treatment

Despite the name, people with lupus anticoagulant antibodies do not necessarily have systemic lupus erythematosus, a disorder commonly known as lupus, although people with that disorder may have lupus anticoagulants. Lupus anticoagulant antibodies may occur in people with numerous types of autoimmune diseases, but they may also occur with no known cause.

If you receive a diagnosis of lupus anticoagulant antibodies (or antiphospholipid syndrome) from an OB/GYN as a part of recurrent miscarriage testing, be sure to ask your doctor whether you might need to follow up with a general practitioner or specialist for monitoring.

For people with a diagnosis of antiphospholipid syndrome resulting from positive lupus anticoagulants, the treatment is usually low-dose or "baby" aspirin and/or heparin injections during pregnancy. This treatment appears to improve the odds of a successful pregnancy outcome. (Note that so-called "baby" aspirin refers to the small dose; this medication is not safe for babies.)

Although treatment outcomes do vary, the prognosis overall is good. Studies show that treatment of antiphospholipid syndrome with heparin alone can improve live birth rates by 50%, while treatment with low-dose aspirin and heparin combined can improve live birth rates by 71%.

It is important to note that these treatments can increase your risk for third trimester complications, so it is imperative that a physician monitor your treatment throughout the duration of your pregnancy.

A Word From Verywell

While recurring miscarriages can be scary and heartbreaking, take comfort in knowing that even with a diagnosis of lupus anticoagulant antibodies, it is still possible to have a successful pregnancy under the guidance of a physician.

Additionally, while the finding of lupus anticoagulant antibodies may give answers to some, others who test negative for these antibodies may need to continue to have additional testing to attempt to find an explanation as to why they cannot carry a baby to term.