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Management of Thrombosis in Antiphospholipid Syndrome and Systemic Lupus Erythematosus in Pregnancy
Author(s) -
RUIZIRASTORZA GUILLERMO,
KHAMASHTA MUNTHER A.
Publication year - 2005
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1196/annals.1361.105
Subject(s) - medicine , antiphospholipid syndrome , pregnancy , aspirin , low molecular weight heparin , thrombosis , heparin , antithrombotic , venous thrombosis , lupus anticoagulant , anticoagulant , obstetrics , genetics , biology
A bstract : Pregnancy is a high risk period for thrombosis in women with antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE) with antiphospholipid antibodies (aPL). Thrombosis may affect the mother, both in the venous and arterial beds, and also have a role in pregnancy loss. Thromboprophylaxis thus is warranted in most of these women. However, specific regimens containing low‐dose aspirin, unfractionated heparin (UH), low molecular weight heparin (LMWH), and even dicumarinics in some circumstances after the first trimester are still a matter of controversy. Women with previous thrombosis should receive full antithrombotic doses of UH or LMWH during the whole pregnancy. Treatment of pregnancy losses is more debated, consisting of low‐dose aspirin with or without associated heparin. The choice of treatment for a given patient must always take into account the woman's opinion after a careful discussion with the treating physician. Peripartum thromboprophylaxis with LMWH in women receiving aspirin‐only regimens and prevention of osteoporosis in those treated with heparin are considered essential in the medical management of these patients.