There is a belief in the Recurrent Miscarriage community (medical practitioners and sufferers) that baby aspirin (75-81mg) can help prevent future miscarriages. The idea is that it thins the blood slightly, meaning that it flows more easily to the uterus, the placenta and the developing baby. This can be effective if the patient has a known blood thickening/clotting issue, for example:
- the antiphospholipid (aPL) antibody and lupus anticoagulant – this test should be done twice, six weeks apart, when you are not pregnant
Antiphospholipid (aPL) antibodies are known to increase the chance of blood clots. These blood clots can block the blood supply to the foetus, which can cause a miscarriage. (from http://www.nhs.uk/Conditions/Miscarriage/Pages/Diagnosis.aspx)
St Mary’s, London, also perform the TEG test (http://en.wikipedia.org/wiki/Thromboelastography), in which your blood is rushed to be tested straight away, while it’s still fresh to check for clotting disorders. I am due to have this test if and when I am next pregnant. If it is positive, St Mary’s will prescribe 150mg of aspirin.
Many people, health professionals and lay people, advise and would be happy to take baby aspirin ‘just in case’ because it ‘can’t hurt’, and, in the months leading up to MMC3, before and during my pregnancy, I took it daily. I know it thins the blood, because at one stage I was covered in it. But that’s another story. I don’t think it did me any harm (except for maybe enabling me to implant a chromosomally abnormal fertilised egg – I wonder whether it contributed to my uterine lining being ‘less selective’). Baby 3 died of Turner’s Syndrome, and nothing on earth could have prevented that (except, perhaps me being 10 years younger!).
Professors Brosens and Quenby at Coventry do not share the view that aspirin ‘can’t hurt’, in fact they argue that it can be a contributory factor in miscarriage because of the implantation problems it can contribute to. Their article is here: http://www.news-medical.net/news/20130117/Miscarriage-and-molecular-signals-an-interview-with-Prof-Brosens-and-Prof-Quenby.aspx
Whilst it does not directly talk about aspirin here, part of their view is that many women with clotting issues mentioned above had perfectly normal pregnancies, so there must be something else going on. I haven’t seen the data, but that’s what they say. Instead, they recommend heparin injections during pregnancy, which they argue are more beneficial in promoting placenta formation and blood flow. I have been prescribed this for next time, also.
So now I am in the difficult position of having two potentially conflicting action plans from two different top RMC clinics, not to mention the reluctance of my GP to order the heparin injections without first referring me to a haematologist.
Lucky for me, it’s a moot point, for now! But I look forward (!) to arguing for my treatment plan with the top RMC consultants in the country the next time I am pregnant. Because that’s the kind of stress I will need at that point in time.
I’m not a doctor, and I don’t know whether aspirin helps or not. But it is clear that the jury is still out, and more research is needed. It may not prove to be as benign as some people think it is. It certainly does help some women, but my worry is that if that isn’t you, it could just hurt.
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