Pregnancy complicated by the antiphospholipid syndrome.

A patient with previously undiagnosed antiphospholipid syndrome (APS) developed atypical severe preeclampsia at 31 weeks' gestation. Other complications of pregnancy included intrauterine growth retardation, thrombocytopenia and fetal distress necessitating urgent delivery of a live infant. There was a prior history of unexplained jugular venous thrombosis. Prophylaxis against thrombosis was commenced immediately postoperatively and no postpartum complications occurred. Recent evidence supports the use of antepartum prophylaxis with low dose heparin in patients with APS. The role of low dose aspirin, either alone or in combination with heparin, is yet to be determined. Human immunoglobulin may be useful in selected cases. Early diagnosis is a key factor in their management.