High-dose unfractionated heparin therapy in a pregnant patient with antiphospolipid syndrome: a case report

Int J Rheum Dis. 2010 Aug;13(3):e32-5. doi: 10.1111/j.1756-185X.2010.01484.x.

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.

Publication types

  • Case Reports

MeSH terms

  • Anticoagulants / administration & dosage*
  • Antiphospholipid Syndrome / blood
  • Antiphospholipid Syndrome / drug therapy*
  • Aspirin / administration & dosage
  • Blood Coagulation / drug effects*
  • Cesarean Section
  • Drug Monitoring / methods
  • Drug Therapy, Combination
  • Female
  • Fetal Death / prevention & control
  • Heparin / administration & dosage*
  • Humans
  • Infusions, Intravenous
  • Live Birth
  • Partial Thromboplastin Time
  • Pregnancy
  • Pregnancy Complications / blood
  • Pregnancy Complications / drug therapy*
  • Pregnancy, High-Risk
  • Treatment Outcome

Substances

  • Anticoagulants
  • Heparin
  • Aspirin