Obstetric duplex sonography in patients with lupus anticoagulant syndrome

The lupus anticoagulant (LAC) syndrome has recently been described as a potential cause of many cases of preeclampsia. This syndrome is associated with a maternal history of repeated first trimester abortions and second and third trimester demise in utero. Umbilical arterial duplex Doppler systolic/diastolic (S/D) ratios and uterine artery S/D ratios for 28 patients whose pregnancies were complicated by lupus anticoagulant syndrome are presented. Five of the six patients who subsequently delivered fetuses small for gestational age (SGA) demonstrated abnormal umbilical arterial S/D ratios, whereas only two of these patients demonstrated abnormally elevated uterine S/D ratios. Twenty three of 28 patients were treated with aspirin and prednisone throughout gestation; no cases of fetal demise in utero were noted.