TREATMENT OF LUPUS ANTICOAGULANT IN PREGNANCY

狼疮患者服用抗凝剂，一种凝血异常 与循环中的磷脂抗体有关的是 增加静脉和动脉血栓的风险。怀孕了 携带这种抗体的妇女失去胎儿的风险很高， 推测是由于螺旋小动脉水平的血栓形成。 或在胎盘的母体地板内。受影响的妇女 反复妊娠丢失的患者都进行了预防性治疗 在随后的妊娠中出现免疫抑制和 抗凝剂。高危妊娠允许比较 预防性免疫抑制的疗效观察 抗凝在预防血栓形成中的作用有限 具有特定治疗终点的一段时间。我们计划 免疫抑制的前瞻性随机协作试验 高危孕妇与抗凝治疗的对比研究 并将比较胎儿结局和母体结局 这两种方案的安全性。一种特殊的免疫分析将是 用于母体血清抗体水平的测定 为维持正常而量身定制的免疫抑制疗法 血清抗体水平。

Patients with the "lupus anticoagulant", a clotting abnormality associated with circulating antibodies to phospholipids, are at increased risk for both venous and arterial thromboses. Pregnant women with such antibodies are at high risk for fetal loss, presumably due to thrombosis at the level of the spiral arterioles or within the maternal floor of the placenta. Affected women with repeated pregnancy loss have been treated prophyllactically in subsequent pregnancies with immunosuppression and anticoagulation. Pregnancies at risk permit comparison of the effectiveness of prophyllactic immunosuppression or anticoagulation in the prevention of thromboses over a limited period of time with a specific treatment end point. We plan a prospective, randomized collaborative trial of immunosuppression versus anticoagulation for pregnant patients at risk for this complication and will compare both fetal outcome and maternal safety of these two regimens. A specific immunoassay will be used for measurement of maternal serum levels of antibody to tailor immunosuppressive therapies for the maintenance of normal serum antibody levels.