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Postpartum cerebral infarction associated with aspirin withdrawal in the antiphospholipid antibody syndrome
D Lê Thi Huong1, B Wechsler, P Edelman
1Department of Internal Medicine, Groupe Hospitalier Pitié-Salpêtrière, Paris.
We observed 2 cases of antiphospholipid syndrome complicated with hemiparesis appearing after delivery. During pregnancy, both women were systematically treated with aspirin (100 mg/day) in addition to prednisone in the second case. Cerebral infarction appeared a few hours after delivery and 8 days after discontinuation of aspirin. The close temporal relationship between discontinuation of aspirin and stroke occurring in early postpartum period suggests a causal link. If aspirin must be stopped for obstetrical reasons, we think that efficient anticoagulation should be started even if the presence of the antiphospholipid antibodies has been priorly asymptomatic.
We observed 2 cases of antiphospholipid syndrome complicated with hemiparesis appearing after delivery. During pregnancy, both women were systematically treated with aspirin (100 mg/day) in addition to prednisone in the second case. Cerebral infarction appeared a few hours after delivery and 8 days after discontinuation of aspirin. The close temporal relationship between discontinuation of aspirin and stroke occurring in early postpartum period suggests a causal link. If aspirin must be stopped for obstetrical reasons, we think that efficient anticoagulation should be started even if the presence of the antiphospholipid antibodies has been priorly asymptomatic.