Antiphospholipids [Hughes] syndrome pregnancy: a report of three cases and review of the literature

ABSTRACT

Since the discovery of the antiphospholipids syndrome in the early eighties, many clinical conditions have been described in patients with antiphospholipid antibodies. Complications include infertility, recurrent miscarriage and increased perinatal mortality. A more serious complication, however, are episodes of arterial thrombosis during pregnancy and puerperium. We have had six such cases in the last three years, of which, the three with major complications are reported here. The first patient had a combination of sickle cell disease, J3-thalassaemia and antiphospholipid antibodies during pregnancy. Put on heparin prophylaxis, she was delivered at 38 weeks by Caesarean section, but died postnatally of a massive pulmonary embolism. The second patient reported at eight weeks of gestation with evidence of a cerebro-vascular accident. Her condition improved and her pregnancy was terminated. The third, a young woman with a history of infertility, was treated with assisted reproductive technology and became pregnant but had a mid-trimester abortion. Eventually she had a normal gestation with heparin prophylaxis and delivered a live baby. Antiphospholipids syndrome is not uncommon in Bahraini pregnancies. Considering the impact of this disease on reproduction and the range of complications involved, screening of pregnant women with a bad obstetric history or recurrent miscarriage is essential