Lupus anticoagulant and pregnancy

• Published in: American journal of obstetrics and gynecology Vol. 153; no. 3; p. 322
• Main Authors: Lubbe, W F, Liggins, G C
• Format: Journal Article
• Language: English
• Published: United States 01.10.1985
• Subjects: Aspirin - therapeutic use; Autoantibodies - analysis; Autoantibodies - immunology; Blood Coagulation Factors - analysis; Blood Coagulation Factors - antagonists & inhibitors; Blood Coagulation Factors - immunology; Female; Fetal Death - etiology; Fetal Diseases - etiology; Fetal Growth Retardation - etiology; Humans; Immunosuppression; Infant, Newborn; Lupus Coagulation Inhibitor; Lupus Erythematosus, Systemic - immunology; Lupus Erythematosus, Systemic - therapy; Partial Thromboplastin Time; Prednisone - adverse effects; Prednisone - therapeutic use; Pregnancy; Pregnancy Complications - etiology; Pregnancy Complications - immunology; Pregnancy Complications - therapy; Pregnancy Complications, Hematologic - etiology; Pregnancy Complications, Hematologic - therapy; Thrombosis - etiology; Thrombosis - therapy
• ISSN: 0002-9378
• DOI: 10.1016/S0002-9378(85)80124-1

A subset of women with a high rate of fetal wastage is identifiable among those with serologic but not necessarily clinical evidence of connective tissue disease. The presence of lupus anticoagulant in the plasma of a pregnant woman serves as a marker for a high rate of fetal wastage and risk of thrombosis. Lupus anticoagulant is best identified by the activated partial thromboplastin time or kaolin clotting time and can be specifically confirmed by the platelet neutralization procedure. Review of the obstetric literature indicates a total of 49 women with 160 unsuccessful pregnancies and 13 live births. Prednisone in immunosuppressive doses (40 to 60 mg/day) combined with low-dose aspirin (75 mg/day) has been demonstrated to be effective in suppressing activity of lupus anticoagulant in pregnant women and successful pregnancies have been obtained with this treatment. Lupus anticoagulant should be excluded in women with suspected collagen disease, with repeated early abortions and all unexpected late fetal losses.