Successful pregnancy outcome with combination therapy in women with the antiphospholipid antibody syndrome.
Four women with the antiphospholipid syndrome associated with lupus anticoagulant and a poor obstetric history were treated with a combination of glucocorticosteroids, anticoagulants and platelet inhibitor therapy. All patients had at least one previous miscarriage while receiving prednisone and low-dose aspirin. The treatment regimen included: aspirin, dipyridamole, prednisone, and warfarin or heparin. This treatment resulted in a successful pregnancy outcome in all cases, without preeclampsia or recurrence of thrombosis. One patient developed a vertebral compression fracture while receiving heparin and prednisone. Two pregnancies required cesarean delivery for fetal distress at 32 and 34 weeks. All four infant birth weights were appropriate for the gestational age. This regimen may be a therapeutic option for patients with the antiphospholipid antibody syndrome, especially if they have failed other commonly used treatments.
Menashe
Y
Y
Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Ben-Baruch
G
G
Greenspoon
J S
JS
Carp
H J
HJ
Rosen
D J
DJ
Mashiach
S
S
Many
A
A
D000328:Adult; D016736:Antiphospholipid Syndrome / Q000188:drug therapy*; D001241:Aspirin / Q000627:therapeutic use*; D004176:Dipyridamole / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D011241:Prednisone / Q000627:therapeutic use*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011256:Pregnancy Outcome; D014859:Warfarin / Q000627:therapeutic use
D014859:Warfarin; D004176:Dipyridamole; D006493:Heparin; D001241:Aspirin; D011241:Prednisone