ABSTRACT
The first treatment for women with fetal wastage associated with anti-phospholipid antibodies was immunosuppression with corticosteroids—prednisone or prednisolone. The relatively high doses required are associated with significant maternal risks and side effects. The reported complications were not unexpected and have included an increased incidence of gestational diabetes, more frequent infections, and a Cushingoid habitus. Heparin is the main anticoagulant used in the treatment of pregnant women, with or without anti-phospholipid antibodies, in the US Despite widespread use of heparin in pregnancy, there are relatively few reports of obstetric complications from the use of herparin. Clinically significant osteopenia leading to vertebral compression fractures has been reported in less than 10 women treated during pregnancy. Since heparin is widely used for anticoagulation, and pregnancy-associated osteoporosis has been reported in as many women who did not receive heparin, the size of any increased risk is unknown.
