Lupus anticoagulant. Implications for obstetric anaesthetists.
Circulating lupus anticoagulant occurs in 5-37% of all patients with systemic lupus erythematosus. Its occurrence is not restricted to collagen vascular disease states. Lupus anticoagulant causes a prolongation of certain laboratory coagulation studies yet it is associated in vivo with a history of systemic intravascular thromboses. Placental vessels are also affected. Less than one in six pregnancies complicated by the presence of this auto-antibody is successful. Treatment of afflicted parturients with anti-platelet therapy has increased perinatal survival rates. Derangements in the coagulation profile and concomitant anti-platelet therapy confound the rational use of regional anaesthesia in the management of labour and delivery in these high-risk pregnancies.
D000328:Adult; D000768:Anesthesia, General; D000773:Anesthesia, Obstetrical; D001323:Autoantibodies / Q000032:analysis*; D001779:Blood Coagulation Factors / Q000032:analysis / Q000276:immunology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D016682:Lupus Coagulation Inhibitor; D008180:Lupus Erythematosus, Systemic / Q000097:blood* / Q000628:therapy; D007744:Obstetric Labor Complications / Q000097:blood* / Q000628:therapy; D011247:Pregnancy; D013925:Thromboplastin / Q000037:antagonists & inhibitors
D001323:Autoantibodies; D001779:Blood Coagulation Factors; D016682:Lupus Coagulation Inhibitor; D013925:Thromboplastin