1. Heparin therapy for pregnant women with lupus anticoagulant or anticardiolipin antibodies
- Author
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M H, Rosove, K, Tabsh, N, Wasserstrum, P, Howard, B H, Hahn, and K C, Kalunian
- Subjects
Adult ,Cardiolipins ,Heparin ,Placenta ,Pregnancy Complications, Cardiovascular ,Infant, Newborn ,Thrombosis ,Blood Coagulation Factors ,Abortion, Spontaneous ,Pregnancy Complications ,Fetal Diseases ,Obstetric Labor, Premature ,Infarction ,Pregnancy ,Recurrence ,Lupus Coagulation Inhibitor ,Birth Weight ,Humans ,Lupus Erythematosus, Systemic ,Female ,Autoantibodies ,Retrospective Studies - Abstract
Maternal lupus anticoagulants and anticardiolipin antibodies are associated with a syndrome of recurrent pregnancy loss or preterm birth in live-borns, fetal growth retardation, and placental infarction. Fourteen women with one or more abnormal pregnancy outcomes (total 28 losses, one severely growth-retarded premature live-born) and no normal outcomes were treated with full-dose, subcutaneous, twice-daily heparin therapy in subsequent pregnancies. Treatment was started at an estimated gestational age of 10.3 +/- 4.0 (mean +/- SD) weeks (range 6-18), in a mean total daily dosage of 24,700 +/- 7400 units (range 10,000-36,000). Fourteen of 15 pregnancies resulted in live births at 36.1 +/- 1.7 weeks (range 33-39). The mean birth weight percentile was 57 +/- 21 (range 10-90), and Apgar scores were good to excellent. The number of placental infarcts was fewer in treated cases than in previous deliveries. Five fetuses had third-trimester or perinatal problems with no sequelae, four discovered by close maternal-fetal monitoring. There was an increased rate of preterm and cesarean deliveries. Maternal complications of treatment were few and minor, with no hypertension, preeclampsia, or serious drug-related complications. Heparin appears suitable for further investigation in the treatment of this obstetric syndrome.
- Published
- 1990