Treatment for Pregnancy Associated APS

Treatment for Pregnancy Associated APS

Clinical ScenarioRegimen Suggested
Repeatedly positive aPLAs, but no history of pregnancy morbidityNo 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.


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