Lupus anticoagulant and pregnancy

Area of Science:

• Obstetrics and Gynecology
• Immunology
• Hematology

Background:

• A subset of pregnant women experience high fetal wastage, often linked to serologic markers of connective tissue disease.
• Lupus anticoagulant (LA) presence in pregnant women is a significant marker for increased fetal wastage and thrombotic risk.

Purpose of the Study:

• To identify the significance of lupus anticoagulant in pregnancy.
• To review diagnostic methods for LA.
• To evaluate treatment efficacy for improving pregnancy outcomes in LA-positive women.

Main Methods:

• Review of obstetric literature.
• Identification of LA using activated partial thromboplastin time (aPTT) or kaolin clotting time (KCT), confirmed by platelet neutralization procedure.
• Evaluation of treatment outcomes with prednisone and low-dose aspirin.

Main Results:

• Literature review identified 49 women with 160 unsuccessful pregnancies and 13 live births.
• Prednisone (40-60 mg/day) and low-dose aspirin (75 mg/day) effectively suppressed LA activity.
• Successful pregnancies were achieved with this combined treatment regimen.

Conclusions:

• Lupus anticoagulant should be screened for in women with recurrent early abortions or unexpected late fetal losses.
• LA is a critical marker for fetal wastage and thrombosis risk in pregnancy.
• Prednisone and aspirin combination therapy offers a viable treatment for improving pregnancy outcomes in LA-positive women.