Anaesthetic implications of a parturient with antiphospholipid antibody syndrome

Authors

  • Tarandeep Singh Lady Hardinge Medical College
  • Samhati Mondal Ghosh Lady Hardinge Medical College
  • Radhika Agarwala Lady Hardinge Medical College
  • Kanta Rahul Lady Hardinge Medical College

Keywords:

Antiphospholipid antibody syndrome, Low molecular weight heparin, activated partial thromboplastin time

Abstract

Antiphospholipid antibody syndrome (APS) is an acquired autoimmune disorder characterised by venous and/or arterial thromboses. When present in women of reproductive age, it is associated with recurrent loss of pregnancy. Antiphospholipid antibodies are directed against various phospholipids in the body, and include anticardiolipin antibodies and the antibodies responsible for the lupus anticoagulant.1 The prevalence of anticardiolipin antibodies has been reported to be between 2.7 and 7% in the general obstetric population.2–4 For many years, an association between circulating maternal antiphospholipid antibodies and recurrent pregnancy loss has been acknowledged.2–4 Pregnancy loss is thought to be caused by thrombosis of placental vessels. Various interventions have been recommended to assist in the maintenance of the pregnancy until delivery of a live infant. The mainstay of treatment has included low-dose aspirin, either alone or combined with unfractionated heparin (UH) or low-molecular-weight heparin (LMWH).5 However, this anticoagulation predisposes the patient to haemorrhage, and may be a contraindication to regional anaesthesia. Here, we highlight a case of a parturient with APS and discuss the anaesthetic implications.

Author Biographies

Tarandeep Singh, Lady Hardinge Medical College

MBBS, MD (Anaesthesia) Senior Resident Dept of Anaesthesia Lady Hardinge Medical College New Delhi

Samhati Mondal Ghosh, Lady Hardinge Medical College

MBBS, MD student (Anaesthesia) Junior Resident Dept of Anaesthesia Lady Hardinge Medical College New Delhi

Radhika Agarwala, Lady Hardinge Medical College

MBBS, MD (Anaesthesia) Professor Dept of Anaesthesia Lady Hardinge Medical College New Delhi

Kanta Rahul, Lady Hardinge Medical College

MBBS, MD (Anaesthesia) Senior Resident Dept of Anaesthesia Lady Hardinge Medical College New Delhi

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Published

2010-09-23

Issue

Section

Case Studies