AC: The question about how we may prevent miscarriage is the tougher one to answer, although it is possibly the most important question for the couple. Some early studies sometimes suggest a benefit with this or that medicine, but when we eventually study that medicine carefully, we may find that it doesn’t work, or even worse, it is actually harmful.
RBA: Can you give me an example?
AC: A good example of this is aspirin. We use it for women with sticky blood conditions such as antiphospholipid syndrome (APS), and it works to reduce miscarriage in those women. However, even when there is no evidence of a ‘sticky blood’ condition, many clinicians have recommended it and women have diligently taken aspirin in the hope that it will reduce the risk of miscarriage. But when this question was properly researched, the shocking finding was that aspirin resulted in more miscarriages compared with taking the dummy tablets.
Only research can uncover such important findings that help guide treatment for women with miscarriage.
RBA: Hang on a minute. Are you saying that aspirin can increase the risk of miscarriage? And if so, in all women? Or just the ones who don’t have APS or other sticky blood conditions? That’s pretty scary!
AC: This is right, Ruth, it is scary… how a treatment given with best of intentions could achieve exactly the opposite of what was expected. However, I must emphasise: for women with sticky blood conditions, the available evidence is that they will benefit from aspirin and heparin, and if their doctors prescribe these, then it would be a good idea to take them.
However, if there is no evidence of a sticky blood condition, women are well advised to keep a mile away from aspirin, unless their doctor prescribes it to them for some other reason.
