Resolved question:
Hi! I am 37. I have had two healthy pregnancies at the age of 28 and 30.
I had a miscarriage in January at 8 weeks.
My recent lab work shows that i have tested positive for anticardiolipin antibodies IGM. My level is 13. I have also tested positive for anti-nuclear antibodies. It is 1:40.
My prothrombin time w/INR is 12.4. It says (H) which I guess means high. Below it, it says "the PT reagent has been reformulated to eliminate interference from Daptomycin" and it says INR is 1.12. Then it is Activated Partial Thromboplastin Time is 34.1. I had other blood work done (thyroid, etc) and if you need those results let me know. I think they are all normal.
EDIT TO ADD: The ANA is Positive (A) and Speckled (A).
Based on all of this info, what medication (if any) do I need to take while TTC and when I get pregnant? I have had two different doctors in real life, give me two different opinions. I am seeking a third. What would you personally do if you or your wife were in my shoes?
Submitted:
4 Days
Category:
OBGYN
Hello,
Thanks for your query at DoctorSpring.com
I understand your concern
May I request you to please upload the reports?
I really need to look at them instead of reading these typed values.
Also a few more things -
Was all this blood work done just because of the miscarriage?
Did the miscarriage occur after the heartbeat was observed in the fetus?
Have you ever had any adverse pregnancy outcomes or health complications earlier?
Do you have any symptoms of autoimmune disease?
How important is it for you to have a third pregnancy?
Please write back with these details.
Looking forward to hearing from you.
Take care.
Hi - Unfortunately I can't access a scanner at this time, but I can try to be as clear as possible. Thank-you for understanding.
First, it says ANTI-NUCLEAR ANTIBODIES. It says POSITIVE (A). (A means abnormal). Then it says "If positive, ANA titer will follow".
For anticardiolipin IGA antibody it is negative (there are none at all)
For anticardilipin IGG antibody it is negative (there are none at all)
For, anticardiolipin IGM antibody it is 13 (H). (H mieans high)
Below that it says "*** Interpretive guidelines*** Negatve <13 MPL Indeterminate 13-20 MPL LOW POSITIVE 21-80 MPL HIGH POSITIVE >80 MPL
*****Note: So my anticardiolipin IGM antibody is just one number away from being negative. It is 13. It it were 12, it were to be considered negative. It falls in the indeterminate range as you see above.**********
Then it says ANA TITER.
It says my ANA TITER is 1:40. (I have learned this is the LOWEST for a positive.) On the next page, it says it is SPECKLED (A). I believe (A) means abnormal.
On the next page it says Prothrombin Time w/INR. Mine is listed at 12.4 (H). It says the reference range is 9.6-12.0. Then below that it says "The PT reagent has been reformulated to eliminate interference from Daptomycin" and it says my INR is 1.12. That is under IN RANGE.
Below that it says "Activated Partial Thromboplastin Time." Mine is listed as 34.1 which is under IN RANGE. It says the reference range is 26.2 - 38.6.
Basically the only abnormal results are 1) I have antinuclear antibodies at 1:40 2) I have positive anticardiolipin antibodies but it is in the indeterminate range, and is just one number away from being negative and 3) My prothrombin time is 12.4 when the range is 9.6-12.0 so it is 4 seconds too high.
NOTE: My thyroid, iron level, check for diabetes etc is all normal.
In answering your questions:
Was all this blood work done just because of the miscarriage?
Yes, I asked my doctor if he could please test me to see if I have a blood clotting disorder. Normally they will wait until you have 3 miscarriages, but he was nice to test me after just one miscarriage.
Did the miscarriage occur after the heartbeat was observed in the fetus?
No. My doctor did say it measured at about 6 weeks. My HCG levels were initially very good during the first week though and doubled appropriately. Also my progresterone was fine.
Have you ever had any adverse pregnancy outcomes or health complications earlier?
I had two healthy pregnancies at the age of 28 and 30. I have only had one miscarriage (a few months ago). So, in answering your question, no I have one had one miscarriage.
Do you have any symptoms of autoimmune disease?
No I have no symptoms that I know of of autoimmune disease. I have no pain in my joints.
How important is it for you to have a third pregnancy?
It is extremely important to me, but at the same time I do not want to risk my life or harm my baby.
I hope this is not too confusing. I can try my best to use a scanner if necessary, but I feel this info is sufficient. I am glad to have an opportunity to contact you and I am very interested in your opinion. It sounds like you are very knowledgeable and have lots of experience.
I look forward to hearing back from you!!!!! Thank-you!!!!!!!!!!
Thank you for your kind words.
Thank you for the information too.
I can understand the effort and patience that you have invested in typing out all the reports for me.
But please understand things from my perspective as a medical professional.
I actually need to see the reports , and trying to understand all the typed information is confusing for me.
I sincerely request you to upload the reports,
It will be a worthwhile thing to scan the reports and upload them.
That is how you will benefit the most from this consultation.
I will await the reports then.
Thank you for your time and patience too.
Take care.
A few more details too -
What is your height and weight ?
Was the miscarriage tissue sent for histopathological analysis for chromosomal disorders ?
That is the most important investigation , if you had a miscarriage before even a heartbeat was observed in the fetus.
Regards.