Lupus anticoagulant in pregnancy

BJOG: An International Journal of Obstetrics and Gynaecology - Tập 91 Số 4 - Trang 357-363 - 1984
Welma Lubbe1, W. S. Butler2, S.J. Palmer3, G. C. Liggins4
1Department of Medicine, Green Lane Hospital and University of Auckland, Honorary Consultant Physician to the National Women's Hospital, Auckland
2Department of Haematology, National Women's Hospital, Auckland
3Department of Haematology, Green Lane Hospital, Auckland
4Professor of Obstetrics and Gynaecological Endocrinology, Postgraduate School of Obstetrics and Gynaecology, School of Medicine, University of Auckland

Tóm tắt

summaryIn a group of 10 women with circulating lupus anticoagulant 25 intrauterine deaths were previously documented in the nine multigravidae. The presence of lupus anticoagulant activity was confirmed by showing prolongation of the activated partial thromboplastin time and kaolin clotting time with failure of correction of the prolongation on incubation with normal plasma. A clinical diagnosis of systemic lupus erythematosus (SLE) was made in four women. Three had deep vein thrombosis in pregnancy, one chorea gravidarum while two had only recurrent fetal losses. All the women had positive antinuclear antibody tests and blood platelet counts <175 × 109/1. Anti‐smooth muscle antibody and VDRL tests were each positive in half the patients; anti‐DNA antibody was present in two patients with clinically active SLE. In six pregnancies correction of the activated partial thromboplastin and kaolin clotting time was attempted using prednisone (40–60 mg/day); aspirin, 75 mg/day, was added. Five live infants were obtained, four by spontaneous delivery, when the restoration of the clotting abnormalities to normal was achieved. In one woman presenting with extensive deep vein thrombosis a live infant was delivered following therapeutic doses of heparin and low dose aspirin. Maternal lupus anticoagulant activity has major implications for pregnancy and should be excluded in women with a clinical suspicion of SLE, a positive antinuclear antibody test, thrombotic episodes, biologically false‐positive VDRL and unexplained late or repetitive early fetal losses.

Từ khóa


Tài liệu tham khảo

10.1002/art.1780190603

10.1016/S0140-6736(81)92087-0

10.1111/j.1471-0528.1981.tb02224.x

10.7326/0003-4819-77-4-543

Conley C. L., 1952, A hemorrhagic disorder caused by circulating anticoagulant in patients with disseminated lupus erythematosus, J Clin Invest, 31, 651

10.1111/j.1365-2141.1978.tb03648.x

Feinstein D. I., 1972, Acquired inhibitors of blood coagulation, Prog Hemostasis Thromb, 1, 75

10.1016/S0140-6736(80)90361-X

Grigor R. R., 1977, Outcome of pregnancy in systemic lupus erythematosus, Proc R Soc Med, 70, 99

10.1111/j.1471-0528.1983.tb08950.x

10.1016/S0140-6736(83)92141-4

10.1016/S0140-6736(81)91992-9

10.7326/0003-4819-92-2-156

10.1111/j.0954-6820.1975.tb04897.x

Sanfellipo M. J., 1981, Prekallikrein inhibition associated with the lupus anticoagulant, Am J Clin Path, 77, 275, 10.1093/ajcp/77.3.275

Soulier R. P., 1980, Avortements a repetition, thromboses et anticoagulant circulant antithromboplastine, Nouv Presse Med, 9, 244

10.1056/NEJM198210073071502

10.1172/JCI109869

Yin E. T., 1965, Purification and kinetic studies on a circulating anticoagulant in a suspected case of lupus erythematosus, Thromb Diathesis Haemorrh, 14, 88

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Thông tin xuất bản

BJOG: An International Journal of Obstetrics and Gynaecology

Tập 91 Số 4

357-363

Thông tin tác giả