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Drug combo may prevent miscarriages


Forum: Recurrent Miscarriage and Pregnancy Loss

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  #1  
October 13th, 2006, 04:14 PM
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Drug combo may help stop repeat miscarriages
Prednisone, aspirin, and progesterone an effective treatment, report says


Updated: 1:32 p.m. PT Sept 28, 2006
NEW YORK - For women who experience repeated unexplained miscarriages, the combination of prednisone, aspirin, folate, and progesterone increases their chances of having baby, a team of clinicians from Austria reports in the journal Fertility and Sterility.

Repeat or “recurrent” miscarriage is defined as at least three consecutive spontaneous pregnancy losses before 20 weeks of gestation. While higher maternal age, smoking, drinking, and other factors can raise the risk of miscarriage, oftentimes the cause is unknown.

Prednisone, aspirin, and progesterone have been reported to be effective in reducing recurrent unexplained miscarriage, Dr. Clemens B. Tempfer and colleagues at the University of Vienna School of Medicine point out, but combinations of these treatments have not been evaluated in clinical trials.

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In their study, Tempfer’s team treated 50 women with recurrent miscarriage with prednisone and progesterone for the first 12 weeks of gestation; aspirin for 38 weeks of gestation; and folate throughout their pregnancies.

They compared the clinical outcomes and side effects in these women to that of 52 untreated subjects of similar age and number of miscarriages.

Women treated with prednisone, progesterone, aspirin and folate had a considerably higher birth rate than untreated subjects, the investigators report. The overall birth rates were 77 and 35 percent, respectively.

The rates of first- and second-trimester miscarriage also favored the treatment group. Nineteen percent of treated women miscarried in the first trimester compared with 63 percent of comparison women. None of the treated women miscarried in the second trimester compared with 2 percent of untreated women.

“In addition, we did not note a higher rate of preterm birth or (fetal) growth restriction among the treatment group,” Tempfer’s team reports.

“Our data indicate that a combination of treatment consisting of high-dose, low-duration prednisone and aspirin, progesterone, and folate might be an effective treatment for women with (unexplained) recurrent miscarriage,” the investigators conclude. They call for more trials to confirm these results.
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  #2  
October 13th, 2006, 05:50 PM
beck12's Avatar Platinum Supermommy
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I am familiar withe stats on Prgoesterone & aspirin - but not prednisone. Prednisone would scare me a bit as there can be soem fairly serious side-effects for mom & I thought baby as well from what I knew. I will have to look into it more.
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  #3  
October 13th, 2006, 07:21 PM
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Lisa,
Thanks for bringing that to our attention. I have been looking into all of these treatments based on my many abnormal test results. With the possibility that my last m/c was the result of pregnancy induced APL syndrome (I had a spike of anticardiolipin that went away 6 weeks after the D&C) I'm already on the aspirin and will also be on Lovenox next pg. We all know the basis for the progesterone. Luckey me, I also had an anti-nuclear antibody level of 1:300 (anthing >1:40 is positive). My OB doesn't seem concerned, but I have found info about this being a cause of recurrent m/c's and infertility. The treatment is sometimes prednisone. The problem as Becky has pointed out are some nasty side effects for mom. I'm still researching the effects on baby. There have been so few studies not much is known. So basically what they did in this study was treat 3 of the most common causes of m/c simultaneously.

insufficient progesterone levles
clotting disorders
immunologic mechanisms (LA, ANA, APL, as well as inate immunity i.e. NK cells)

If it wasn't for the side effects and limited research on the prednisone it would be the miracle cocktail for most women with recurrent m/c's. It pretty much covers everything except genetic abnormalities. And which one of us wouldn't give anything for a miralce..... I wish it was this simple.
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  #4  
October 14th, 2006, 09:06 AM
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Okay I am not sure about what you said there with the antinuclear stuff...Can you explain it a little more??
I am on aspirin too and my OB wants me on some kind of heparin as well next pregnancy...I am going to ask my RE about this next time I see her....
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  #5  
October 14th, 2006, 04:07 PM
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Thank you for posting this. I too am worried about side effects and of course the effect on the baby. I would definitely love to hear about any other research you all have found on the various treatments.
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  #6  
October 14th, 2006, 06:56 PM
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heparin and lovenox are used in clotting disorders.

i do have a question about the immunologic mechanisms...is this something the hematologist tests for? i know i have gotten alot of blood work done in his office and some of it sounds familiar from there. does it have anything at all to do with the clotting disorders? i have never worried about the factor v, i am in the lower risk group for this, and the hematologist is only doing this as precautionary and does not believe it has much to do with what has gone on. my next appt with him is the 20th of this month, any advice on what i should ask or is there any specific bloodwork/tests i can ask him to do? any info would be appreciated.
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  #7  
October 16th, 2006, 08:56 AM
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Interesting theory, I hadn't seen that one before. Please remember that JM policy requires that you post the link and not the full text of the article to avoid copyright issues.

On the prednisone, I take that every time I get bronchitis, pneumonia, or a serious asthma episode - very nasty stuff. At my last asthma checkup (~4-6w pg), my allergist told me I will NOT take prednisone while pg due to the risks to the baby, even knowing that I had bronchitis 3 times and pneumonia once all within 4 months last year. Maybe the researchers used a lighter dose than I take for respiratory issues, but that wasn't covered in the article. It's definitely not something to consider lightly. Prednisone also lowers your immune system function for up to a year (which may be part of the reasoning for using it to increase pg success - prevent the body from attacking the fetus), which means you could spend a lot of your pg fighting colds or worse.
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