Related Experiment Videos
Maternal and fetal complications associating lupus anticoagulant and its management; three case reports
A P Makar1, J S Vanderheyden, A Verheyen
1Sint Augustinus University Hospital, Department of Obstetrics and Gynaecology, Wilrijk-Antwerpen, Belgium.
Insights
Antiphospholipid antibodies, including lupus anticoagulant and anticardiolipin antibody, are linked to pregnancy complications. This study highlights rare maternal and fetal issues arising from these conditions and their treatments.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Immunology
Background:
- Antiphospholipid antibodies (aPL), such as lupus anticoagulant (LA) and anticardiolipin antibody (aCL), are associated with thrombosis, fetal loss, and thrombocytopenia.
- Diagnosis typically involves prolonged phospholipid-dependent coagulation tests.
- While LA management during pregnancy with corticosteroids and aspirin is documented, maternal and fetal complications remain underreported.
Observation:
- This report details three cases of significant maternal and fetal complications in patients with LA managed over three years.
- Complications arose from antiphospholipid syndrome or its treatment.
- Observed maternal issues included gastritis, muscle atrophy, premature contractions, pre-eclampsia, and one case of lymphoma.
Findings:
- Fetal complications encompassed prematurity, temporary suprarenal insufficiency, and delayed neuromuscular development.
- Some reported complications, including lymphoma and specific maternal/fetal issues, appear novel in the literature.
- These findings underscore the complex risks associated with aPL during pregnancy.
Implications:
- Highlights the need for vigilant monitoring of both maternal and fetal health in pregnancies complicated by antiphospholipid antibodies.
- Suggests potential for previously undocumented adverse outcomes related to aPL and their management.
- Informs clinical practice regarding the comprehensive risk assessment and management strategies for pregnant individuals with antiphospholipid syndrome.
Abstract:
Both lupus anticoagulant and anticardiolipin antibody are groups of antiphospholipid antibodies associated with high frequency of thrombosis, fetal loss and thrombocytopenia. The hall marks of their identification is the prolongation of phospholipid-dependant coagulation tests. Much is written in literature about the successful management of lupus anticoagulant during pregnancy, via corticosteroid and acetyl salicylic acid (Aspirin) therapy; however, up to now only little has been mentioned about maternal and fetal complications associating lupus anticoagulant and its management. Here we present three cases with significant complications among patients with lupus anticoagulant managed in Sint Augustinus Hospital over the last 3 years. These complications were secondary to antiphospholipid syndrome or to therapy. Maternal complications included gastritis, atrophy of quadriceps muscle, resistant premature contractions and pre-eclampsia. One of our patients developed small lymphocytic lymphoma 1 year after her last labour. Fetal complications included: prematurity, suprarenal insufficiency (temporary) and delayed neuromuscular development found at the 2 year follow-up. As far as we know, some of these complications have never been mentioned in literature.