Treatment for Pregnancy Associated APS
| Clinical Scenario | Regimen Suggested |
|---|---|
| Repeatedly positive aPLAs, but no history of pregnancy morbidity | No treatment or consider low dose aspirin Consider prophylactic dose heparin for 6 weeks postpartum in patients with LAC and/or high-titer aPLAs due to risk of thrombosis |
| High-risk repeatedly positive aPLAs + less than three consecutive pregnancy lossesTriple positive or LAC+ | Consider prophylactic dose heparin and aspirin a |
| All SLE patients during pregnancy +/– aPLAs Patients with a history of preterm birth due to preeclampsia and positive aPLAs | Low dose Aspirin |
| Women with SLE and/or APS with pregnancy failure despite treatment with low-dose aspirin Patients with severe preeclampsia and +aPLAs | Aspirin plus prophylactic dose heparin or LMWH |
| Patients with +aPLAs and a prior thrombotic event (meets criteria for APS prior to pregnancy) Pregnancy loss with +aPLAs despite prophylactic dose heparin and aspirin a | Full dose LMWH and aspirin |
aPLAs, Antiphospholipid antibodies; LAC, lupus anticoagulant; LMWH, low molecular weight heparin; SLE, systemic lupus erythematosus.
