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Purpose  This study aimed to assess the efficacy of high‐dose i.v. immunoglobulin ( HIVI g) therapy in pregnant women with antiphospholipid syndrome ( APS ) secondary to systemic lupus erythematosus with a history of pregnancy failure, despite receiving low‐dose aspirin plus unfractionated heparin therapy, of which condition being designated as “aspirin–heparin‐resistant  APS ” ( AHRAPS ).    Methods  The  HIVI g therapy (20 g/d, 5 days) was performed for the pregnancies of five women with  AHRAPS .    Results  Five of the eight pregnancies ended in live births. The gestational ages of delivery in four of the five pregnancies were extended, compared with previous pregnancies. The  HIVI g therapy was considered to be successful for these four pregnancies. Excluding one pregnancy that ended in miscarriage with an abnormal chromosome karyotype of the villi, the  HIVI g therapy was considered to be successful in four (57.1%) of the seven pregnancies of the women with  AHRAPS . Although all the live newborns were prematurely delivered, no adverse effect of the  HIVI g therapy was observed.    Conclusions  The  HIVI g therapy might be beneficial as an immune modifier for pregnant women with  AHRAPS . However, the precise indication of which women with  AHRAPS  who should receive  HIVI g therapy remains unknown.

Effectiveness of high‐dose i.v. immunoglobulin therapy for pregnant women with aspirin–heparin‐resistant secondary antiphospholipid syndrome