Eur J Anaesthesiol 2021 09;38(9):916-922
From the Systemic Autoimmune Disease Unit, Department of Internal Medicine, Vall d'Hebron University Hospital, Department of Medicine, Universitat Autonoma (JA-R, JP-G), Internal Medicine Department, Althaia Healthcare University Network of Manresa, Systemic Autoimmune Disease Unit, Manresa (EE-V), High Risk Unit, Obstetric Department, Quirón University Hospital, Barcelona (RF-O), Internal Medicine Department, Miguel Servet University Hospital, Zaragoza, Spain (LS-C), Haematology Unit, Hippokration Hospital of Thessaloniki, Greece (EL), AP-HP, Hôpital Saint-Antoine, Service de Médecine Interne and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Sorbonne Universités, UPMC University, Paris (AM), Vascular and Coagulation Department, University Hospital Angers, Angers, France (CB), Rheumatology Unit, Department of Clinical and Experimental Medicine Azienda Ospedaliera, University of Padua, Padua (AR), Rheumatology and Clinical Immunology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Spedali Civili, Brescia (AT, CN), Department of Obstetrics and Gynaecology, Università di Torino, Torino, Italy (LM), Systemic Autoimmune Diseases Service, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain (GE), Department of Gynaecology, Gemmelli Hospital, Catholic University, Rome, Italy (SDeC), Autoimmune, Thrombophilic Diseases and Pregnancy Division, Dr Carlos G Durand Hospital, Buenos Aires, Argentina (OL, US), Obstetrics and Gynaecology Department, High Risk Unit, University Hospital de la Santa Creu i Sant Pau, Barcelona, Spain (ELL), Immunorheumatology Research Laboratory, Istituto Auxologico Italiano (LT), Division of Rheumatology, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy (CC), Cardiology Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua (VP), Pregnancy and Rheumatic Diseases Clinic Unit of Medicine and Clinical Immunology IRCCS Ospedale San Raffaele Università Vita-Salute San Raffaele, Milano, Italy (PR-Q, VC), Department of Obstetrics, Medical University Graz, Graz, Austria (KM-P), Department of Systemic Rheumatic Disease, V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia (TR), Department of Gynecology Obstetrics and Urology, "Sapienza" University of Rome, Rome, Italy (ST) and Clinical Research Unit, Althaia Healthcare University Network of Manresa, Barcelona, Catalonia Central University, Manresa-Vic, Spain (AA).
Background: The combination of low-dose aspirin (LDA) and low-molecular-weight heparin (LMWH) until the end of gestation are the currently the accepted standard of care for the treatment of antiphospholipid-related obstetric disorders. In refractory cases, hydroxychloroquine (HCQ) can be added to this standard of care.
Objective: To evaluate the haemostatic safety of LDA and LMWH (medium to high prophylactic doses) during pregnancy and the puerperium in women with both full-blown obstetric antiphospholipid syndrome (OAPS) (Sydney criteria) and noncriteria - incomplete - OAPS. Read More