Approach to the pregnant and postpartum woman with antiphospholipid syndrome or antiphospholipid antibodies

aPL: antiphospholipid antibody; LMWH: low molecular weight heparin; ASA: acetylsalicylic acid; APS: antiphospholipid syndrome; CAPS: catastrophic antiphospholipid antibody syndrome; SLE: systemic lupus erythematosus.
* Patients with suspected APS should have testing for lupus anticoagulant, anticardiolipin antibodies, and anti-beta-2-glycoprotein-1 antibodies. For those in whom one of the antibodies is detected, testing should be repeated in 12 or more weeks. Refer to UpToDate content on aPL testing.
¶ The anticoagulation regimen is the same, regardless of whether or not the woman has a history of an APS-defining pregnancy morbidity.
Δ APS-defining pregnancy morbidity includes ≥1 fetal losses at ≥10 weeks of gestation, ≥1 preterm deliveries of a morphologically normal infant before 34 weeks of gestation due to severe preeclampsia, eclampsia, or other findings consistent with placental insufficiency, or ≥3 unexplained consecutive spontaneous pregnancy losses <10 weeks of gestation.
◊ Antithrombotic management differs in cases of ASA failure or when placental examination shows extensive decidual inflammation and vasculopathy and/or thrombosis. Refer to UpToDate content on pregnancy and APS.