High‐dose unfractionated heparin therapy in a pregnant patient with antiphospholipid syndrome: a case report |
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| Authors: | Hiroshi OGISHIMA Satoshi ITO Akito TSUTSUMI Makoto SUGIHARA Daisuke GOTO Isao MATSUMOTO Mana OBATA‐YASUOKA Hiromi HAMADA Hiroyuki YOSHIKAWA Hideto TAKAHASHI Atsuko MURASHIMA Takayuki SUMIDA |
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| Institution: | 1. Division of Clinical Immunology, Doctoral Program in Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki;2. Department of Rheumatology, Niigata Rheumatic Center, Shibata, Niigata;3. Department of Internal Medicine, Takikawa Municipal Hospital, Takikawa, Hokkaido;4. Institute of Obstetrics and Gynecology in Clinical Medicine, University of Tsukuba, Tsukuba, Ibaraki;5. Epidemiology and Biostatistics, School of Medicine, University of Tsukuba, Tsukuba, Ibaraki;6. Division of Maternal Medicine, National Center for Child Health and Development, Setagaya, Tokyo, Japan |
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| Abstract: | A case of a 37‐year‐old pregnant patient with antiphospholipid syndrome (APS), who has a medical history of both thrombosis and recurrent fetal loss, is presented. She was treated with predonisolone and fixed‐dose unfractionated heparin (UFH) infusion, followed by plasmaphereses and fixed‐dose low‐molecular‐weight heparin infusion during her fourth pregnancy. Unfortunately, this treatment did not have beneficial effects, resulting in intrauterine growth restriction and finally neonatal death. Continuous intravenous UFH infusion and low‐dose aspirin were administrated under the monitoring of the activated partial thromboplastin time to achieve a target level of 120 s during her fifth pregnancy. A healthy baby weighing 1818 g at birth was delivered by Cesarean section at the 34th week of pregnancy. High‐dose UFH infusion may be considered to be one of the preferable options to manage pregnant patients with refractory APS. |
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| Keywords: | activated partial thromboplastin time anticoagulation antiphospholipid syndrome heparin high intensity pregnancy |
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