title: Obstetric performance in patients with the lupus anticoagulant and/or anticardiolipin antibodies.
abstract: Antiphospholipid antibodies, notably the lupus anticoagulant and anticardiolipin antibodies, are associated with recurrent fetal wastage, pregnancy complications, and thromboses. Aggressive medical treatment using aspirin and steroids has been recommended. Fifty-one patients with antiphospholipid antibodies, only four with underlying connective tissue disorders, were followed through 53 pregnancies. Aggressive therapy was used in 33 pregnancies, 90.9% of which resulted in successful obstetric outcomes, a highly statistically significant difference compared with previous pregnancies in the same patients. Most pregnancies among nine patients receiving single-agent therapy (aspirin or steroids alone) and eight patients not treated also had successful outcomes. A 48.6% complication rate was found in association with therapy, particularly gestational diabetes mellitus. There was no statistical correlation between dose or duration of therapy and development of treatment-related complications. Although a subgroup of patients with antiphospholipid antibodies will benefit from aggressive therapy, the high complication rate warrants close observation.
authors.affiliation: Department of Obstetrics and Gynecology, George Washington University Medical Center, Washington, DC.
authors.forename: H J
authors.initials: HJ
authors.lastname: Landy
authors.forename: C
authors.initials: C
authors.lastname: Kessler
authors.forename: W K
authors.initials: WK
authors.lastname: Kelly
authors.forename: A B
authors.initials: AB
authors.lastname: Weingold
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D016736:Antiphospholipid Syndrome / Q000188:drug therapy / Q000453:epidemiology*; D001241:Aspirin / Q000627:therapeutic use; D002308:Cardiolipins / Q000276:immunology*; D004359:Drug Therapy, Combination; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D016682:Lupus Coagulation Inhibitor / Q000032:analysis*; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*
chemical_list: D000305:Adrenal Cortex Hormones; D002308:Cardiolipins; D016682:Lupus Coagulation Inhibitor; D006493:Heparin; D001241:Aspirin