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Fetal Demise Associated with Lupus Anticoagulant: Clinical Features and Results of Treatment

 

作者: H.J.A. Carp,   Y. Frenkel,   A. Many,   Y. Menashe,   S. Mashiach,   L. Nebel,   V. Toder,   D.M. Serr,  

 

期刊: Gynecologic and Obstetric Investigation  (Karger Available online 1989)
卷期: Volume 28, issue 4  

页码: 178-184

 

ISSN:0378-7346

 

年代: 1989

 

DOI:10.1159/000293573

 

出版商: S. Karger AG

 

关键词: Abortion;Fetal death;Lupus anticoagulant

 

数据来源: Karger

 

摘要:

There are many reports in the literature associating lupus anticoagulant with fetal death. Successful pregnancies have been reported following suppression of the antibody by prednisone and the addition of antiaggre-gants and possibly anticoagulants. This report describes our experience treating such patients and the outcome of subsequent pregnancies. The results are less successful than the figures in the literature, 13 live births out of 27 pregnancies in 19 patients. This may be due to lupus anticoagulant being diagnosed as the cause for a wide variety of clinical presentations including habitual first trimester abortion, mid trimester fetal death, intrauterine growth retardation and placental dysfunction in the third trimester. Our experience shows that steroids and antiaggregants have a definite place in cases of second and third trimester fetal death and in cases of clinical systemic lupus erythematosus. However, lupus anticoagulant is one of a spectrum of autoantibodies whose pathophysiology has not been fully elucidated. It is questionable whether this regimen of treatment has a place in patients with no previous fetal loss or in cases of primary habitual abortion.

 

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