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Multiple thromboses in a premature infant associated with maternal phospholipid antibody syndrome
S Tabbutt1, W R Griswold, M T Ogino
1Department of Pediatrics, University of California School of Medicine, Children's Hospital and Health Center, San Diego.
Insights
Phospholipid antibodies in mothers can lead to fetal loss and infant thrombosis. Careful monitoring for thromboembolism is crucial in infants born to mothers with these antibodies.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Medicine
- Immunology
Background:
- Phospholipid antibodies, including lupus anticoagulant and cardiolipin, are linked to recurrent fetal loss.
- Current treatments for mothers with phospholipid antibodies include prednisone, aspirin, or heparin to prevent fetal death.
Observation:
- A case study of a neonate born to a mother with cardiolipin antibody and a history of recurrent fetal loss, treated with prednisone and aspirin.
- Placental fetal vessel thrombosis was observed in utero.
Findings:
- The neonate developed widespread arterial thromboses, affecting the aorta, renal artery, middle cerebral artery, and superior sagittal sinus.
- This suggests a potential link between maternal phospholipid antibodies and neonatal vascular thrombosis.
Implications:
- Infants born to mothers with phospholipid antibodies require vigilant monitoring for signs of thromboembolism.
- Early detection and management of neonatal thrombosis may improve outcomes.
Abstract:
Phospholipid antibodies (lupus anticoagulant, cardiolipin) are associated with a syndrome of repeated fetal loss. Mothers with phospholipid antibodies are currently being treated with either prednisone, aspirin, or heparin to prevent fetal death. We describe a neonate whose mother had cardiolipin antibody and recurrent fetal loss and was treated with prednisone and aspirin. Thrombosis was noted in placental fetal vessels. Thromboses developed in the infant's aorta, left renal artery, middle cerebral artery, and superior sagittal sinus. Infants of phospholipid-positive mothers may have vascular thrombosis and should be carefully monitored for signs of thromboembolism.