APL

Question 1

Laboratory Criteria for Diagnosis of Antiphospholipid Syndrome

Answer 1

Each of these on 2 occasions >12 weeks apart:

1) lupus anticoagulant
2) anticardiolipin (IgG or M)
3) anti-β2-glycoprotein I (IgG or M)

Question 2

Clinical Criteria for Diagnosis of Antiphospholipid Syndrome

Answer 2

1- Vascular thrombosis
One or more arterial, venous, or small vessel thrombosis

2- Pregnancy morbidity

a) 1 or more unexplained IUFD beyond the 10th week with normal fetal morphology documented by ultrasound or by direct examination of the fetus OR
b) 1 or more PTD of morphologically normal neonate before 34 wk GA week of gestation because of eclampsia or severe preeclampsia, or features consistent with placental insufficiency OR
c) 3 or more unexplained consecutive SAB before 10wk GA 10th week of pregnancy, with other causes excluded.

Question 3

Obstetric Complications w/APL

Answer 3

Fetal and Recurrent Pregnancy Loss
Preeclampsia/Eclampsia
IUGR

Question 4

How should antiphospholipid syndrome be managed during pregnancy and the postpartum period?

Answer 4

Both women who have and haven’t had a thrombotic event: prophylactic anticoagulation and low dose ASA throughout pregnancy and 6 weeks postpartum.

Question 5

Appropriate contraception?

Answer 5

Pregnancy and the use of estrogen-containing oral contraceptives appear to increase the risk of thrombosis. Progesterone–only forms of contraception are appropriate

Question 6

should women with antiphospholipid syndrome have antepartum surveillance?

Answer 6

Yes, serial US assessment and antepartum testing in the third trimester.