This protocol covers the management of antiphospholipid syndrome in female patients who are antiphospholipid antibody positive and have experienced specific obstetric complications — with no history of thrombotic events.
The patient is a woman with confirmed antiphospholipid antibody positivity who has had two or more recurrent spontaneous miscarriages before the 10th week of gestation, or a delivery at or after the 34th week of gestation complicated by severe pre-eclampsia or eclampsia. There is no prior history of thrombotic events. This constitutes a 'non-criteria' obstetric APS presentation.
An antiplatelet strategy may be considered for this scenario, either as a standalone approach or in combination with anticoagulant support, selected according to the individual patient's risk profile. Which option applies — and under what circumstances — is determined by the full structured regimen.
With clinical 'non-criteria' obstetric APS such as the presence of two recurrent spontaneous miscarriages <10th week of gestation, or delivery ≥34 weeks of gestation due to severe pre-eclampsia or eclampsia, treatment with LDA alone or in combination with heparin might be considered based on the individual's risk profile.
DOI: 10.1136/annrheumdis-2019-215213
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