The facts on Antiphospholipid Syndrome: one of the main causes of recurrent miscarriage.

Every year, hundreds of Australian women will experience recurrent miscarriage. And while many will never receive answers about the cause of their pregnancy loss, a handful will be given a little known diagnosis: Antiphospholipid Antibody Syndrome.

But it’s not just women who experience APS. Often known as Hughes Syndrome or Sticky Blood Syndrome, this lifelong disease and its potentially deadly symptoms can be experienced by men as well.

So what is Antiphospholipid Syndrome? What causes it? And is there treatment available?

Let’s break it down.

What is Antiphospholipid Syndrome?

APS is an autoimmune disorder in which abnormal proteins, called antibodies, attack platelets in the blood causing them to clump together. People with APS have thickened circulating blood and are more likely to experience potentially dangerous clots in their veins, blood vessels and organs.

There are two types of Antiphospholipid Syndrome. The most common is Primary APS, in which the condition occurs on its own. The other is Secondary APS, in which it occurs in association with another health problem, such as Systemic Lupus.

There is no cure for Antiphospholipid Syndrome, but treatments are available that significantly reduce the risk of complications.

What causes Antiphospholipid Syndrome?

The cause of Antiphospholipid Syndrome is unknown. But according to Dr Talat Uppal, an obstetrician and clinical senior lecturer at the University of Sydney, women are between three to five times more likely to be diagnosed with the condition than men. Most cases, she says, tend to occur among people aged between 30 and 50.

What are the symptoms of Antiphospholipid Syndrome?

Without treatment, the most common symptoms of APS include:

• Blood clots, which can lead to heart attack, stroke or pulmonary embolism (blockage in the arteries that supply blood to the lungs).
• Migraine headaches.
• Low blood platelet count.
• Mottled skin tone; a purplish lace-like purplish pattern on the skin.
• Miscarriage and pregnancy complications.

As Dr Uppal explains, “APS generally either gets picked up because somebody has a family history; for example, someone’s sister had a clot so therefore they get screened. Or because a woman has had recurrent miscarriages, that is three consecutive miscarriages in the first trimester.”

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Antiphospholipid Syndrome and pregnancy.

Untreated Antiphospholipid Syndrome comes with an increased risk of recurrent miscarriage. But as Dr Uppal explains, it’s still relatively rare: “Only one percent of women have recurrent miscarriage, and then only 15 percent of that group is found to have Antiphospholipid Syndrome.”

But there are other possible pregnancy complications associated with APS, too.

“Even when they get to more advanced pregnancy, they still have a higher chance of having a baby that is growth restricted… So it’s important to have regular scans,” Dr Uppal said. “The other thing is that there can have preterm labour or even pre-eclampsia [high blood-pressure]. These are the kind of things we, as clinicians, watch out for when we know that women have Antiphospholipid Syndrome.”

It’s not all doom and gloom, though.

“[With proper treatment] 80 per cent of women have a take-home baby, which is very good news,” Dr Uppal said. “So the majority of women will have a happy, healthy pregnancy once they are treated.”

What treatments are available?

Treatment for APS is blood thinning medication, which prevents clots from forming. This generally includes a prescribed, low-dose Aspirin and a blood-thinning agent.

Dr Uppal stresses that certain blood-thinning agents can be toxic to an unborn baby, and should not be used during pregnancy. Pregnancy-safe alternatives are available.

“It’s very important for someone who has Antiphospholipid Syndrome and wants to be pregnant to identify that [to their doctor], so that the haematologist can work with them to try and get them on something that’s not a problem during pregnancy,” she said.

Dr Uppal says that it’s important to note that while being diagnosed with a life-long condition can be overwhelming, with vigilance from patients and their clinicians, these treatments are very successful.

“It can be quite disheartening to have [APS], but I always bring patients back to the positive: there are things that get diagnosed that don’t have a solution, but this is a problem with a solution.”

If you have experienced pregnancy loss and are in need of support, please call the 24-hour SANDS Australia helpline on 1300 072 637.