Anaesthesia and the antiphospholipid syndrome: a review of 20 obstetric patients

Anesthetic management of HELLP syndrome complicating primary antiphospholipid syndrome -A case report-

“…APS was first described in 1983 and requires the following clinical findings to diagnose: venous or arterial thrombosis, recurrent pregnancy loss and/or thrombocytopenia, together with moderate to high levels of IgG and/or IgM anticardiolipid antibodies or a positive lupus anticoagulant test [6]. Although obstetric problems include pre-eclampsia, eclampsia and placental thrombosis with premature delivery frequently occurring in these patients, HELLP syndromes complicating APS reports are rare and this paper is unique in a Korean woman.…”

Anaesthesia for caesarean delivery in a parturient following a recent cerebrovascular event

“…Transient ischaemic episodes secondary to thrombosis have been reported during pregnancy in these patients. 8 Their coagulation status is complex. The tendency is towards hypercoagulability, although traditional laboratory assays for coagulation may be abnormal.…”

“…8 Central neuraxial blockade has been reported in the presence of significantly prolonged laboratory values for APTT without adverse consequences. 8 Low-dose aspirin may contribute to complications with regional techniques but clinically in isolation has not led to greater complications. 9 Thromboelastography is a non-specific global test of coagulation that can detect both hypo-and hypercoagulability.…”

Anaesthetic considerations for patients with antiphospholipid syndrome undergoing non-cardiac surgery

“…103 If acute postoperative hypoxaemia develops, PTE should be suspected. 82 In a report of 20 cases involving pregnant women with APS, two patients were observed to experience postpartum PTE, 104 and postoperative hypoxaemia was stated to be an early sign of PTE that requires immediate intervention. In a case involving a patient with APS who developed PTE after elective hepaticojejunostomy, the patient was reported to have a history of DVT on two occasions and acute cyanosis 3 days following surgery.…”