A woman has antiphospholipid syndrome (APS) confirmed by laboratory criteria with recurrent early pregnancy loss. The RECOMMENDED treatment to reduce recurrent miscarriage in APS is:

• A Low molecular weight heparin (LMWH) alone throughout pregnancy
• B Low-dose aspirin (75–100 mg daily) commenced pre-conception plus LMWH from positive pregnancy test ✓
• C Warfarin sodium 5 mg daily throughout pregnancy
• D Prednisolone 5–40 mg daily plus aspirin

Explanation

For obstetric APS with recurrent early pregnancy loss (3 or more losses <10 weeks), the established treatment is low-dose aspirin (75–100 mg) commenced pre-conceptionally combined with prophylactic-dose LMWH (enoxaparin 40 mg once daily or equivalent) from positive pregnancy test onwards. This combination increases live birth rates from approximately 40% untreated to 70–80%. Warfarin is teratogenic in the first trimester and contraindicated. High-dose steroids add toxicity without proven benefit. LMWH alone without aspirin is less well established.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.