Antiphospholipid Syndrome in Pregnancy with a History of Thrombotic APS
This protocol covers the management of antiphospholipid syndrome in a specific high-risk situation: a female patient who is pregnant and has a confirmed prior history of thrombotic APS.
Clinical scenario: Pregnancy in a woman with established thrombotic antiphospholipid syndrome. This combination requires a defined anticoagulant strategy that accounts for both the pregnancy itself and the pre-existing thrombotic risk.
Treatment Approach — Partial Overview
Management during pregnancy involves a combination anticoagulant and antiplatelet strategy. Adjustments to the anticoagulation regimen are also required at a specific early gestational threshold. The complete regimen, agent selection, and gestational timing are detailed in the full protocol.
References
- In women with a history of thrombotic APS, combination treatment of LDA and heparin at therapeutic dosage during pregnancy is recommended.
- Switching treatment from VKA to therapeutic dose LMWH or UFH is recommended as soon as pregnancy is confirmed, ideally before the sixth week of gestation due to the teratogenic effects of warfarin.
DOI: 10.1136/annrheumdis-2019-215213
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