A 30-year-old woman has had three consecutive first-trimester miscarriages. Testing shows persistent lupus anticoagulant positivity confirmed 12 weeks apart. What is the evidence-based treatment for her next pregnancy?
- A Prophylactic low molecular weight heparin plus low-dose aspirin ✓
- B Low-dose aspirin alone
- C Oral prednisolone throughout the first trimester
- D Intravenous immunoglobulin every 4 weeks
Correct answer: A. Prophylactic low molecular weight heparin plus low-dose aspirin
Explanation
Antiphospholipid antibody syndrome with recurrent pregnancy loss is treated with prophylactic dose heparin combined with low-dose aspirin, which raises live birth rates substantially compared with aspirin alone. Prednisolone and intravenous immunoglobulin have been tested and shown to add risk or confer no benefit. Aspirin monotherapy is inadequate because the thrombotic placental microvasculopathy requires anticoagulation.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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