Recurrent miscarriages caused by APS

Miss H suffered a miscarriage when she was 15 weeks pregnant in 2011.  On examination of the baby at her local hospital there was no evidence of any congenital anomaly or infection.  No further tests or investigations were carried out and no cause for the miscarriage was identified.  Miss H and her partner continued to try and conceive naturally but without success and in 2014 she underwent IUI, a type of fertility treatment, which was provided by the NHS at another NHS Trust.  This treatment led to a positive pregnancy but sadly this ended in an early miscarriage.

To continue with fertility treatment Miss H was advised that she would need to pay privately and so she paid over £3,000 for two further cycles of IUI.  The second treatment again was successful but ended in miscarriage and the third treatment failed.  Shortly afterwards Miss H and her partner ‘s relationship broke down.

In 2018 Miss H discovered she was pregnant again but tragically this also ended in her miscarrying a fourth baby.  However, this time she was referred to a Miscarriage Clinic.  Various blood tests were performed which confirmed that she had a positive antibody, Anti-Beta-2 glycoprotein-l (aB2GPl), for Antiphospholipid Syndrome (APS), an autoimmune condition of hypercoagulation which is a treatable cause of recurrent miscarriage.  To prove the diagnosis, Miss H had a further blood test taken some 12 weeks or so later and again the result was positive.  It was confirmed that APS may be the cause of her repeated miscarriages and so in any future pregnancies she would need blood thinning treatment in the form of heparin and aspirin.

Miss H asked us to investigate the standard of care she had received from two NHS Trusts.  With the assistance of an expert in Obstetrics and Fertility medicine we confirmed that all women with recurrent first-trimester miscarriage and all women with one or more second trimester miscarriage should be screened before pregnancy for antiphospholipid antibodies.  Therefore, we could say that Miss H should have been tested and diagnosed with APS in 2011 and before she was offered fertility treatment.  As a result of these breaches of duty, she suffered 3 heart breaking miscarriages causing psychological injury and she endured and incurred the cost of invasive and uncomfortable fertility treatment which was always bound to fail.

Formal Letters of Claim were sent to both Trusts involved in Miss H’s care.  The Trust responsible for the fertility treatment denied that the treatment they had provided was negligent.  We disagreed with this view and the claim was ultimately settled in Miss H’s favour on behalf of both Trusts and she recovered a five figure settlement.

In this case there were multiple opportunities to diagnose Miss H’s condition over a number of years but this was not a bar to her bringing a claim as she sought our assistance as soon as she learned of her diagnosis.

Ashleigh Holt – May 2021