Question

Which of the following is recommended in a woman with antiphospholipid antibodies and a history of prior abortions or still birth?

• A. Aspirin only
• B. Aspirin plus low molecular weight heparin
• C. Aspirin plus low molecular weight heparin plus prednisolone
• D. No treatment

Hint:

Placental clotting is the enemy; combine an antiplatelet with an anticoagulant, and skip the steroid.

Answer 1

The Correct Option is B

Begin with the problem. Antiphospholipid antibodies create a clotting tendency, and in pregnancy clots form in the placenta and cause miscarriage or stillbirth. So the treatment must thin the blood and stop placental thrombosis.

The evidence based answer for a woman who already has antibodies and a record of pregnancy loss is dual therapy: low dose aspirin plus low molecular weight heparin. Aspirin curbs platelet stickiness while heparin blocks the clotting cascade, and the pair has been shown to raise the chance of a successful live birth. That is option B.

Why not the others. Aspirin by itself, option A, underperforms the combination once there is a history of loss, so it is reserved for milder situations. Adding prednisolone, option C, was tried in the past but it does not help outcomes and brings steroid harms such as gestational diabetes and preterm delivery, so it is dropped. Doing nothing, option D, abandons a high risk pregnancy to repeat loss and is unacceptable.

Hence the recommended plan is aspirin together with low molecular weight heparin.
\[\boxed{\text{Aspirin plus low molecular weight heparin}}\]