Anesthesia with antiphospholipid antibodies: anesthetic management of a parturient with lupus anticoagulant and anticardiolipin antibody.
The anesthetic management of a parturient with a circulating lupus anticoagulant and an anticardiolipin antibody presenting to the obstetric suite taking heparin and aspirin is discussed. Issues concerning placement of a regional anesthetic with recent aspirin ingestion and heparin therapy are discussed. Documentation of heparin dissipation via a whole blood heparin concentration assay before induction of regional anesthesia, including several laboratory tests that could be used in monitoring coagulation status in this patient population, is discussed in detail.
Fahy
B G
BG
Department of Anesthesiology, University of Maryland School of Medicine, Baltimore 21201, USA.
Malinow
A M
AM
D000328:Adult; D000758:Anesthesia; D000773:Anesthesia, Obstetrical; D000906:Antibodies / Q000276:immunology*; D000925:Anticoagulants / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D002308:Cardiolipins / Q000276:immunology*; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D016682:Lupus Coagulation Inhibitor / Q000276:immunology*; D010743:Phospholipids / Q000276:immunology*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications / Q000276:immunology*
D000906:Antibodies; D000925:Anticoagulants; D002308:Cardiolipins; D016682:Lupus Coagulation Inhibitor; D010743:Phospholipids; D010975:Platelet Aggregation Inhibitors; D006493:Heparin; D001241:Aspirin