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Case Reports
. 2022 Nov 2;50(2):154-158.
doi: 10.1159/000526349. eCollection 2023 Apr.

Triple Positive Antiphospholipid Antibody Syndrome in Pregnancy with High Frequency Plasma Exchange: A Case Report

Jesse Cottrell  1 , Ahlim Al Sanani  2 , Iheanyichukwu Ogu  2 , David Chaffin  1
Affiliations
Case Reports

Triple Positive Antiphospholipid Antibody Syndrome in Pregnancy with High Frequency Plasma Exchange: A Case Report

Jesse Cottrell et al. Transfus Med Hemother. .

Abstract

Introduction: Triple antibody positive antiphospholipid syndrome during pregnancy carries a poor prognosis. The placental vasculature is particularly vulnerable to these antibodies resulting in a marked increased risk of fetal growth restriction, placental infarction, abruption, stillbirth, and preterm severe preeclampsia.

Case presentation: We report a case of a primigravida with triple antibody positive antiphospholipid syndrome that demonstrated placental insufficiency and fetal compromise at a previable gestation. The patient underwent plasma exchange every 48 h for 11 weeks resulting in delivery of a viable infant. Placental blood flow was improved after complete absence of end-diastolic flow in the fetal umbilical artery.

Conclusion: Scheduled plasmapheresis every 48 h can be considered in select cases of antiphospholipid antibody syndrome.

Keywords: Antiphospholipid antibody syndrome; Low molecular weight heparin; Plasma exchange; Plasmapheresis; Pregnancy; Triple positive antibodies.

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Conflict of interest statement

The authors have no conflicts of interest to declare. The views expressed in this submitted article are strictly the view of the authors and not an official position of the institution.

Figures

Fig. 1.
Fig. 1.
Patient timeline from preconception to postdelivery. Weeks and days of gestation abbreviated as XwXd.
See this image and copyright information in PMC

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