A 30-year-old G4P0L0 woman has had three consecutive first-trimester miscarriages. Evaluation shows persistent lupus anticoagulant positivity on testing done 12 weeks apart. What is the recommended management in her next pregnancy?
- A Low-dose aspirin combined with prophylactic low molecular weight heparin ✓
- B Low-dose prednisolone continued throughout pregnancy
- C Monthly intravenous immunoglobulin infusions
- D Hydroxychloroquine monotherapy throughout pregnancy
Correct answer: A. Low-dose aspirin combined with prophylactic low molecular weight heparin
Explanation
Antiphospholipid antibody syndrome is the most common treatable cause of recurrent pregnancy loss, and the combination of low-dose aspirin with prophylactic heparin substantially improves live birth rates in these women. Corticosteroids were abandoned for this indication because they add maternal morbidity such as gestational diabetes and hypertension without improving fetal outcomes. Immunoglobulin and hydroxychloroquine have no established role as first-line therapy.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.