Q.8. what uncommon drugs for Rec Abortions that are occasionally used?? If her RA factor / SLE tests or her clinical symptoms pertaing to SLE worsen she may require immune modulation. Ask her history of MTX administration for SLE or Rh arthritis in the recent past...
Q.9. Preconceptionally what else measure though besides empirical use of Ecosprin in cases of RSA?? Doxycycline (? Chlamydia) Preconceptionally in addition to FA. Ecosprin. Many of us prescribe one course of Doxy to both partners and when put + one may add LMWH, but one has to make ensure she is not in luteal phase while starting doxy
What is everyone's take on immunoglobulin’s in such with evidence of activity like presence of Anti Rho La Smyth and CCP and a gamut. Occasionally one can combine Comparison of LMWH and immunoglobulin can try bharglob inj. monthly. And ecosprin..
Q.10. what should be the dose of ecosprin? As several people above already suggested aspirin 81 mg daily and enoxaparin 40 mg subcut once a day ( dose adjusted is she is unusually obese or thin) I would also one can think of adding some prednisolone, in next pregnancy, to be started as soon as she knows she’s pregnant,
It is often mentioned not to start any DMARD without endorsements and full evaluation by the immunologist. Safe dose without affecting HPOA is 7.5 mg OD.
, the main reason I am thinking of prednisolone is that she has probably already been on aspirin and enoxaparin in prev pregnancies after the 2nd, 3 rd losses.
Q.12. to consult an immunologist after 2 or 3 abortions:-An immunology input wills b helpful at this point.
Q.9. Preconceptionally what else measure though besides empirical use of Ecosprin in cases of RSA?? Doxycycline (? Chlamydia) Preconceptionally in addition to FA. Ecosprin. Many of us prescribe one course of Doxy to both partners and when put + one may add LMWH, but one has to make ensure she is not in luteal phase while starting doxy
What is everyone's take on immunoglobulin’s in such with evidence of activity like presence of Anti Rho La Smyth and CCP and a gamut. Occasionally one can combine Comparison of LMWH and immunoglobulin can try bharglob inj. monthly. And ecosprin..
Q.10. what should be the dose of ecosprin? As several people above already suggested aspirin 81 mg daily and enoxaparin 40 mg subcut once a day ( dose adjusted is she is unusually obese or thin) I would also one can think of adding some prednisolone, in next pregnancy, to be started as soon as she knows she’s pregnant,
It is often mentioned not to start any DMARD without endorsements and full evaluation by the immunologist. Safe dose without affecting HPOA is 7.5 mg OD.
, the main reason I am thinking of prednisolone is that she has probably already been on aspirin and enoxaparin in prev pregnancies after the 2nd, 3 rd losses.
Q.12. to consult an immunologist after 2 or 3 abortions:-An immunology input wills b helpful at this point.
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