Antiphospholipid Syndrome

Question 1

Diagnosis of APLS?

Answer 1

One clinical AND one laboratory criteria are met

Question 2

Clinical Criteria for APLS?

Answer 2

1. Any vascular thrombosis
2. Pregnancy morbidity (any one)
   - 1 fetal loss >/= 10 wks
   - PTD < 34 wks due to Severe Pre E, FGR
   - >/= 3 SAB < 10 weeks (excluding maternal or chromosomal abnormalities)

Question 3

Laboratory criteria for APLS?

Answer 3

1. Anti B2 glycoprotein Ab (IgM/IgG)
2. Lupus Anticoagulant
3. Anticardiolipin Ab (IgM and/or IgG)

Criterion must be present on two or more occasions at least 12 weeks apart

Question 4

APLS management in Pregnancy?

Answer 4

• Maternal monitoring for Pre E, VTE
• Fetal monitoring for FGR (serial growth US)
• If NO prior VTE, consider ppx UFH/LMWH + ASA 81 mg
• If PRIOR VTE, recommend ppx UFH/LMWH + ASA 81 mg
• Anticoagulation continued for 6 wks PP

**No estrogen containing contraception (progesterone OK if no PE)