When a Miscarriage Isn't Nature's Way

A Closer Look at Autoimmune Disordes

By Virginia Gilbert

Years ago, I miscarried at 12 weeks. I sat in my OB's office insisting this loss wasn't nature's way of handling an unviable arrangement of chromosomes. Citing my nagging intuition, I asked to be tested for autoimmune disorders, which I'd read could cause miscarriage. My OB kindly and patiently convinced me doing the necessary blood work would waste time and money. She saw no evidence to indicate that my miscarriage was anything out of the ordinary.

But the evidence showed up in spades when I got pregnant again several months later; my routine syphilis test came back positive. A more sophisticated blood panel confirmed the obvious: I did not have a venereal disease. What I did have, however, were unusually high levels of antinuclear antibodies, which can cause a false positive syphilis result. After I underwent more lab work, I learned I had Antiphospholipid Antibody Syndrome (APS), an obscure, enigmatic autoimmune condition that more often affects women, many of whom don't even know they have it until their pregnancies go awry. Only 8 weeks along, I was classified as a high-risk obstetric patient and began anticoagulant therapy to keep from miscarrying again.

So what is this little-known culprit with a fancy name? In simplest terms, APS is an autoimmune disorder in which the body doesn't recognize parts of its own cells and creates antibodies to attack them. According to Dr. Victoria A. Seligman, a rheumatology fellow at the University of California, San Francisco, APS is diagnosed when a patient has one or more of the following criteria: