Anesthesia with antiphospholipid antibodies: Anesthetic management of a parturient with lupus anticoagulant and anticardiolipin antibody

• Published in: Journal of clinical anesthesia Vol. 8; no. 1; pp. 49 - 53
• Main Authors: Fahy, Brenda G., Malinow, Andrew M.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-02-1996
• Subjects: Adult; Anesthesia; Anesthesia, epidural; Anesthesia, Obstetrical; Antibodies - immunology; anticardiolipin antibody; Anticoagulants - therapeutic use; Aspirin - therapeutic use; Cardiolipins - immunology; Female; Heparin - therapeutic use; Humans; lupus anticoagulant; Lupus Coagulation Inhibitor - immunology; Phospholipids - immunology; Platelet Aggregation Inhibitors - therapeutic use; Pregnancy; Pregnancy Complications - immunology; thrombosis; thrombosis; lupus anticoagulant; anticardiolipin antibody; Anesthesia, epidural
• ISSN: 0952-8180; 1873-4529
• DOI: 10.1016/0952-8180(95)00175-1

The anesthetic management of a parturient with a circulating lupus anticoagulant and an anticardiolipin antibody presenting to the obstetric suite taking heparin and aspirin is discussed. Issues concerning placement of a regional anesthetic with recent aspirin ingestion and heparin therapy are discussed. Documentation of heparin dissipation via a whole blood heparin concentration assay before induction of regional anesthesia, including several laboratory tests that could be used in monitoring coagulation status in this patient population, is discussed in detail.