ANTIPHOSPHOLIPID SYNDROME

Antiphospholipid syndrome (APS) is an autoimmune disorder defined by both
the presence of characteristic clinical features and circulating antiphospholipid
antibodies. Diagnosis requires that at least one clinical and one laboratory
criterion are met.

The clinical criteria for diagnosis and indications for lab testing include:

The lab criteria require that one or more of the following three antiphospholipid
antibodies be positive on ≥2 occasions at least 12 weeks apart.

Management: For antepartum anticoagulation management, the following is
recommended:

Vascular    thrombosis: ≥1  clinical    thrombotic  episodes    (arterial,  venous, or

small   vessel)

Pregnancy   morbidity   (unexplained):  ≥1  fetal   demise  at  ≥10 weeks;  ≥3

consecutive miscarriages    at  <10 weeks

Lupus   anticoagulant

Anticardiolipin antibody    (lgG    &   IgM)

Anti-132-glycoprotein   I   (lgG    &   IgM)

APS without a   thrombotic  event:  no  heparin or  only    prophylactic    heparin

APS with    a   thrombotic  event:  prophylactic    heparin