Antiphospholipid syndrome

Acute thrombotic events—treat as appropriate with heparin/warfarin. Long term anticoagulation is required; target INR 2.5-3.5 depending on clinical risk of recurrence.

Recurrent abortion—subsequent pregnancies have been successfully achieved in women with the antiphospholipid syndrome with combined aspirin and heparin (UFH or LMWH) begun as soon as pregnancy is confirmed. Steroids are not indicated.

Prophylactic anticoagulation—pregnancy in a woman with APL and a past history of thrombosis will require prophylactic anticoagulation with heparin (ffl p588).

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