Treatment of pregnant patients with antiphospholipid syndrome

A. Tincani, W. Branch, R. A. Levy, J. C. Piette, H. Carp, R. S. Rai, M. Khamashta, Y. Shoenfeld, Barbara Acaia, Marie Helene Arusseau, Marie Claire Boffa, Richard Cervera, Ronald Derksen, David Faden, Ricardo Frestiero, Nigel E N Harris, Michael Lockshin, Gale McCarty, Pierluigi Meroni

Research output: Contribution to journalArticle

Abstract

Antiphospholipid Syndrome (APS) has been widely recognized as a risk factor for the recurrence of both thrombosis and pregnancy losses; however the optimal treatment of patients is debatable. The aim of this paper was to establish a consensus among experts on the treatment of APS in pregnancy. A questionnaire that described possible different clinical situations was sent to the International Advisory Board of the 10th International Congress on Antiphospholipid Antibodies. Sixteen experts from different medical branches and different geographic areas sent their replies. The consensus was that treatment for APS pregnant patients should be low molecular weight heparin (LMWH) and low dose aspirin (LDA). The dosage, and frequency of LMWH depends on different situations, including the body weight and past history. Patients with previous thromboses usually receive two injections per day. Warfarin can also be used from 14 to 34 weeks, for patients with previous stroke or severe arterial thromboses. The use of intravenous immunoglobulin (1VIG) seems to be restricted to patients with pregnancy losses despite conventional treatment. The experts usually advised barrier methods of contraception, intrauterine device (if the patient is not taking corticosteroids) or progestins. Oral contraception with oestrogens was usually avoided.

Original languageEnglish
Pages (from-to)524-529
Number of pages6
JournalLupus
Volume12
Issue number7
DOIs
Publication statusPublished - 2003

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Keywords

  • Antiphospholipid syndrome
  • Pregnancy
  • Thrombosis prophylaxis
  • Treatment

ASJC Scopus subject areas

  • Rheumatology
  • Immunology

Cite this

Tincani, A., Branch, W., Levy, R. A., Piette, J. C., Carp, H., Rai, R. S., Khamashta, M., Shoenfeld, Y., Acaia, B., Arusseau, M. H., Boffa, M. C., Cervera, R., Derksen, R., Faden, D., Frestiero, R., Harris, N. E. N., Lockshin, M., McCarty, G., & Meroni, P. (2003). Treatment of pregnant patients with antiphospholipid syndrome. Lupus, 12(7), 524-529. https://doi.org/10.1191/0961203303lu393oa