Blood · Pregnancy · Visual journey
A blood clot in the leg and a pregnancy loss can have the same root cause: antibodies that attack your own body. Either one can be the first sign.
It’s more common in women, but it also affects men, and it can start at any age.
Plug at the tearPlatelets held in place by strands of fibrinBlood vessel
When a blood vessel tears, platelets, which are fragments of cells, plug the tear and fibrin weaves a mesh over it. Without an injury, clotting stays switched off.
Under the microscope
A clot lodged in an artery in the lung: pale layers of fibrin and platelets alternate with red layers of red blood cells. In this syndrome, blood clots too easily, in both veins and arteries.
Take a closer lookUnder the microscope
Those alternating layers are called lines of Zahn.
The cause
Four steps, from the body’s normal defenses to a clot.
They tag germs so your body can destroy them.
They attack normal proteins in your blood.
The protein under attack changes shape and switches on clotting even though there’s no injury.
Clots form in veins and arteries, and pregnancy complications become more likely. Still, some people have these antibodies and never get a clot.
A clot in a deep vein (in the leg, thigh or pelvis) is called deep vein thrombosis. If a piece travels to the lungs and blocks an artery, that’s a pulmonary embolism.
A clot can cause a heart attack or a stroke.
The other sign
It’s linked to pregnancy loss, preeclampsia (high blood pressure brought on by pregnancy), premature birth and a placenta that doesn’t grow as much as it should.
VillusThe baby’s blood inside; the mother’s blood outsideThe baby’s blood flows inside the villi, and the mother’s blood surrounds them. Oxygen and nutrients pass across without the two ever mixing.
With this syndrome, the placenta can implant poorly, and the arteries in the uterus don’t widen.
Without enough blood, part of the placenta dies. This is called an infarct. It looks pale, with no blood between the villi.
What you can control
There’s no cure, but treatment prevents new clots and keeps existing ones from growing. And people with this syndrome can have successful pregnancies.
What you can do
Testing is offered after an unexplained clot, three or more pregnancy losses, a loss between weeks 16 and 34, or severe preeclampsia before week 34.
The diagnosis is confirmed with blood tests repeated about three months apart, in someone who has had a blood clot or pregnancy complications.
Why it helps: there’s treatment to prevent another clot and to help you plan a future pregnancy.
Without treatment, the risk of pregnancy loss and preeclampsia goes up. There are medicines to prevent clots, and ultrasounds to keep an eye on the baby.
Don’t stop taking them on your own, and tell your doctor everything you take, even supplements. Check with your doctor before any procedure or new medicine: birth control that contains estrogen raises the risk of clots.
I’m your friend, Dr. Carlo De la Sancha. Health and Science for all.
What does a placenta with infarcts look like?
Watch the video “This placenta has infarcts” In the two textbook illustrations, the label lines were erased and the edges were blended into the background; none of the anatomy was redrawn. The opening microscope image is a version of the clot micrograph with more depth and contrast. The infarct micrograph was only adjusted for contrast and sharpness.
Educational content for the general public. It doesn’t diagnose antiphospholipid syndrome or recommend treatment. Diagnosis and any decisions about blood thinners or a pregnancy are up to your health care team.
