Maternal and fetal complications associating lupus anticoagulant and its management; three case reports.
Both lupus anticoagulant and anticardiolipin antibody are groups of antiphospholipid antibodies associated with high frequency of thrombosis, fetal loss and thrombocytopenia. The hall marks of their identification is the prolongation of phospholipid-dependant coagulation tests. Much is written in literature about the successful management of lupus anticoagulant during pregnancy, via corticosteroid and acetyl salicylic acid (Aspirin) therapy; however, up to now only little has been mentioned about maternal and fetal complications associating lupus anticoagulant and its management. Here we present three cases with significant complications among patients with lupus anticoagulant managed in Sint Augustinus Hospital over the last 3 years. These complications were secondary to antiphospholipid syndrome or to therapy. Maternal complications included gastritis, atrophy of quadriceps muscle, resistant premature contractions and pre-eclampsia. One of our patients developed small lymphocytic lymphoma 1 year after her last labour. Fetal complications included: prematurity, suprarenal insufficiency (temporary) and delayed neuromuscular development found at the 2 year follow-up. As far as we know, some of these complications have never been mentioned in literature.
Makar
A P
AP
Sint Augustinus University Hospital, Department of Obstetrics and Gynaecology, Wilrijk-Antwerpen, Belgium.
Vanderheyden
J S
JS
Verheyen
A
A
D000328:Adult; D001241:Aspirin / Q000009:adverse effects / Q000494:pharmacology; D001323:Autoantibodies / Q000502:physiology; D001779:Blood Coagulation Factors / Q000276:immunology* / Q000378:metabolism; D002308:Cardiolipins / Q000276:immunology; D004359:Drug Therapy, Combination; D005260:Female; D005313:Fetal Death / Q000209:etiology; D005756:Gastritis / Q000209:etiology; D006801:Humans; D007213:Indomethacin / Q000494:pharmacology; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000209:etiology; D016682:Lupus Coagulation Inhibitor; D007752:Obstetric Labor, Premature / Q000188:drug therapy / Q000209:etiology; D011241:Prednisone / Q000009:adverse effects / Q000494:pharmacology; D011247:Pregnancy; D011248:Pregnancy Complications; D012312:Ritodrine / Q000494:pharmacology; D013921:Thrombocytopenia / Q000209:etiology; D013927:Thrombosis / Q000209:etiology
D001323:Autoantibodies; D001779:Blood Coagulation Factors; D002308:Cardiolipins; D016682:Lupus Coagulation Inhibitor; D012312:Ritodrine; D001241:Aspirin; D011241:Prednisone; D007213:Indomethacin