High-dose unfractionated heparin therapy in a pregnant patient with antiphospolipid syndrome: a case report.
A case of a 37-year-old pregnant patient with antiphospholipid syndrome (APS), who has a medical history of both thrombosis and recurrent fetal loss, is presented. She was treated with predonisolone and fixed-dose unfractionated heparin (UFH) infusion, followed by plasmaphereses and fixed-dose low-molecular-weight heparin infusion during her fourth pregnancy. Unfortunately, this treatment did not have beneficial effects, resulting in intrauterine growth restriction and finally neonatal death. Continuous intravenous UFH infusion and low-dose aspirin were administrated under the monitoring of the activated partial thromboplastin time to achieve a target level of 120 s during her fifth pregnancy. A healthy baby weighing 1818 g at birth was delivered by Cesarean section at the 34th week of pregnancy. High-dose UFH infusion may be considered to be one of the preferable options to manage pregnant patients with refractory APS.
Ogishima
Hiroshi
H
Division of Clinical Immunology, Doctoral Program in Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan. ogishima@md.tsukuba.ac.jp
Ito
Satoshi
S
Tsutsumi
Akito
A
Sugihara
Makoto
M
Goto
Daisuke
D
Matsumoto
Isao
I
Obata-Yasuoka
Mana
M
Hamada
Hiromi
H
Yoshikawa
Hiroyuki
H
Takahashi
Hideto
H
Murashima
Atsuko
A
Sumida
Takayuki
T
D000925:Anticoagulants / Q000008:administration & dosage*; D016736:Antiphospholipid Syndrome / Q000097:blood / Q000188:drug therapy*; D001241:Aspirin / Q000008:administration & dosage; D001777:Blood Coagulation / Q000187:drug effects*; D002585:Cesarean Section; D016903:Drug Monitoring / Q000379:methods; D004359:Drug Therapy, Combination; D005260:Female; D005313:Fetal Death / Q000517:prevention & control; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D007262:Infusions, Intravenous; D050498:Live Birth; D010314:Partial Thromboplastin Time; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000188:drug therapy*; D018566:Pregnancy, High-Risk; D016896:Treatment Outcome
D000925:Anticoagulants; D006493:Heparin; D001241:Aspirin