Pregnancy loss with phospholipid antibodies: improved outcome with aspirin containing treatment

The obstetric outcome in 37 patients with antiphospholipid antibodies (APAs) is described. The APAs were measured by the lupus anticoagulant assay and/or more recently anticardiolipin antibodies. There were 15 patients with SLE who without therapy had 51/58 pregnancy failures, either abortion or fetal death in utero, a failure rate of 88%. Likewise, 22 patients without definite SLE lost 69/87 pregnancies, a failure rate of 79%. After treatment the pregnancy wastage rate was 55% and 25% in the 2 groups respectively. When treatment regimens used were examined in detail the improvement with therapy was most clearly evident in the group who received low dose aspirin (75-150 mg) in association with immunosuppression. This improvement was most apparent in the patients without definite SLE.