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Re: Lupus anticoagulant and pregnancy From: Douglas L. Madsen (dlmmd@fidalgo.net) Thu Jul 31 00:36:21 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Douglas L. Madsen: "Re: Prior cesarean, SGA, need your help...." Previous message: Bernard Cristalli: "Re: Prior cesarean, SGA, need your help...." Maybe in reply to: Douglas L. Madsen: "Lupus anticoagulant and pregnancy" >>The question is, in light of her lab abnormalities should she be considered >>for Heparin and/or steroid administration. My tendency is to not treat >>based solely on lab data, and since her first pregnancy proceeded without >>hypertension, IUGR, etc., I have every reason to expect no different this >>gestation. > >Doug: > >I'm assuming the diagnosis of LAC is based on those abnormal clotting >studies after mixing with normal plasma. YES > >Does your patient have any clinical features (not pregnancy related) that >would support the diagnosis of antiphospholipid syndrome i.e., thrombosis, >thrombocytopenia, livedo reticularis? NONE OF THE ABOVE > >I would personally offer her the option of heparin therapy in addition to >baby aspirin ( I prefer low molecular weight heparin, if her carrier will >reimburse), though clearly her prior pregnancy outcome was favorable. I no >longer offer steroids based on literature that suggests excessive risks of >PTD. HAVE DISCUSSED WITH LOCAL PERINATAL GROUP AND PATIENT AND DECISION IS TO RX WITH ASA ONLY AT THIS TIME. WE WILL MONITOR CLOSELY WITH ULTRASOUNDS, NST'S > >Recent references of interest on antiphospholipid syndrome and pregnancy: > >JAMA 5-21-97 pp 1549-1551 >Rheumatic disease clinics of NA; February 1997 > >Best Wishes. > >Steven Laifer >MFM >Bridgeport, CT THANKS AGAIN FOR EVERYONE INPUT. I'LL LET YOU KNOW IF ANYTHING ELSE DEVELOPES. Doug Madsen MD FACOG Mount Vernon, WA Pvt Practice Next message: Douglas L. Madsen: "Re: Prior cesarean, SGA, need your help...." Previous message: Bernard Cristalli: "Re: Prior cesarean, SGA, need your help...." Maybe in reply to: Douglas L. Madsen: "Lupus anticoagulant and pregnancy"

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