[Circulating anticoagulants and pregnancy: a risky combination]

Area of Science:

• Obstetrics and Gynecology
• Hematology
• Immunology

Context:

• The link between lupus anticoagulant and pregnancy complications is established.
• Previous studies show poor outcomes for pregnancies with lupus anticoagulant.
• High levels of this factor indicate a poor obstetric prognosis.

Purpose:

• To summarize the relationship between lupus anticoagulant and obstetrical complications.
• To highlight diagnostic indicators for lupus anticoagulant.
• To review treatment strategies for improving pregnancy outcomes in affected women.

Summary:

• Lupus anticoagulant presence is associated with spontaneous abortions, fetal deaths, and intrauterine growth retardation.
• Diagnostic suspicion arises from prolonged clotting time (5-7+ seconds) and elevated activated partial thromboplastin time (APTT).
• Literature review indicates only 20 live births from 280 pregnancies in 71 women with the factor.

Impact:

• Early intervention using corticoid-immunosuppressors, heparin, aspirin, and dipyridamole can improve live birth rates.
• Effective management can enable women with lupus anticoagulant to carry pregnancies to term.
• This research underscores the importance of timely diagnosis and treatment for lupus anticoagulant in pregnancy.