Lupus Anticoagulant During Pregnancy - What Is The Danger?

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Why is lupus anticoagulant dangerous?

In the human body, there are many very complex processes that implement metabolism. Most of the indicators of biochemical transformations can be analyzed using laboratory studies. Deviations of some indicators from the norm may be a sign of an onset disease or recovery.

There are a number of biochemical substances that a healthy person should not have under any circumstances. If they appeared even in a minimal amount, this indicates pathology. These substances include VA, or lupus anticoagulant.

The blood clotting process goes through several successive stages. Numerous substances are involved at each stage. On the surface of platelets, the cells responsible for the formation of a blood clot, there are phospholipid molecules that activate proper hemostasis in case of damage to the vascular wall.

Lupus anticoagulants are protein molecules, or class G antibodies, that damage phospholipid molecules and disrupt the smooth process of thrombus formation. VA are autoantibodies that direct their action against their own body and its cells.

Lupus antibodies get their name from the disease "systemic lupus erythematosus", because they were first detected in patients suffering from this pathology.

Diseases and conditions in which they are present in human blood:

• Autoimmune pathologies;
• Advanced stage of HIV infection;
• Oncological diseases;
• Miscarriage and problems with conception with antiphospholipid syndrome in healthy women, manifested by an increased risk of thrombosis;
• Inflammatory process.

The detection of VA is an alarming indicator, since impaired hemostasis affects the successful conception and gestation of pregnancy, causes miscarriages and provokes infertility.

An increased level of lupus anticoagulant in the blood is directly associated with a high risk of thrombus formation, the appearance of blood clots in the veins and arteries of the extremities, microvessels of the skin, in the coronary arteries, and the vessels of the brain. It is almost impossible to predict the appearance of a blood clot, its appearance bears serious consequences:

• Fetal death in late gestation;
• Spontaneous early abortion;
• Stroke and myocardial infarction;
• PE (pulmonary embolism);
• Retinal vascular thrombosis and visual impairment.

Content:

• When to get tested for lupus anticoagulant
• Preparation for analysis
• What the analysis results say

When to get tested for lupus anticoagulant

Analysis for VA is not an ordinary standard study, for its conduct you need a referral from a therapist, gynecologist, rheumatologist, cardiologist to diagnose the pathology of hemostasis.

Indications for determining VA:

• Miscarriages of unknown etiology;
• Non-standard indicators of the cardiogram (excess of APT - activation of partial platelet time);
• Finding out the cause of the increased risk of thrombosis;
• Diagnostics of the antiphospholipid syndrome;
• Infarction of the brain, heart muscle, with transient ischemic attacks in patients under 45 years of age;
• Diagnosis of autoimmune pathologies.

Pathologies of conception and difficulties with bearing a fetus, accompanied by the presence of VA in the blood, indicate that the woman has antiphospholipid syndrome. This is confirmed by the data of a two-time study, eaten with an interval of 6-8 weeks. A positive result in both cases is a sign of the syndrome. These suspicions are confirmed by the presence of signs of pathological thrombosis in a woman:

• Cerebral infarction;
• Heart attack;
• Vascular thrombosis of the extremities;
• Decreased vision;
• History of miscarriages.

Other groups of patients with elevated levels of lupus anticoagulant may not show signs of thrombosis, but still have a tendency to excessive blood clotting. An increased level of VA in them is a sign of autoimmune processes and an increased risk of thrombosis.

If the autoimmune pathology is accompanied by the formation of proteins that oppose the cells of their own body, the increased level of lupus anticoagulant reflects the deplorable position of platelets and other cells against which aggression is directed. If this indicator is found in the blood, immediate prevention of thrombosis is required in order to avoid the development of necrosis and ischemia of various organs.

Preparation for analysis

The main material for conducting a coagulogram and studying VA is blood from a vein.

Since the test result depends on the preparation for the analysis, it is important to follow the rules:

• The last meal should be no later than 8 hours before taking blood for analysis in order to avoid starting metabolic processes with the participation of the enzymatic system and biochemical active substances that could distort the data;
• You can drink water as tea and coffee are prohibited;
• Drinking alcohol is strictly prohibited;
• The day before the analysis, it is undesirable to eat fatty foods that increase the content of fat and protein molecules in the blood;
• Do not smoke 1-2 hours before the study, in order to avoid platelet aggregation;
• Blood-thinning drugs (aspirin, ascorbic acid, NSAIDs) should be temporarily canceled, not taken before taking blood for analysis, inform the laboratory doctor about other drugs in advance;
• The day before, you can not endure physical activity, exercise, sports, perform ultrasound, X-ray examination, and undergo physiotherapy.

The study is carried out in the morning on an empty stomach. Blood is taken from a vein and immediately sent to the laboratory.

What the analysis results say

The norm for a healthy person is a negative test result, since VA does not belong to the necessarily present blood components. If there is no lupus coagulant, then the person does not have antiphospholipid syndrome and autoimmune processes.

The indicator of the norm is 31-44 seconds or 0.8-1.2 cu. units

An increased level of VA or its traces is a sign of impaired hemostasis in the following diseases:

• Rheumatoid arthritis;
• Systemic lupus erythematosus;
• Oncological damage to the hematopoietic organs (myeloma);
• Antiphospholipid syndrome, possibly against the background of pregnancy pathologies;
• Taking certain drugs such as phenothiazine.

False positive test results may be due to the complex intake of blood thinners (Heparin, Hirudin), therefore, the analysis is carried out before starting therapy.

When planning the conception of a child, the analysis for VA is carried out in the presence of a history of frozen pregnancies, fetal death. If a woman is already pregnant, the VA test is done if she has migraines, cyanosis, and numbness of the fingertips.

With the correction of antiphospholipid syndrome in women of fertile age, the likelihood of pregnancy increases many times over. If available, heparin therapy is performed to prevent thrombosis in pregnant women.

The increased risk of blood clots during pregnancy is threatened by the following consequences:

• Hypoxia and fetal death;
• Placental abruption;
• Tela (pulmonary embolism);
• Stroke;
• Cardiovascular pathology;
• Acute renal failure.

If there is a lupus anticoagulant in the blood, therapy is performed, which includes the following drugs:

• Aspirin, heparin, warfarin - correction of antiphospholipid syndrome;
• Glucocorticosteroids dexamethasone, prednisolone - correction of rheumatism, autoimmune processes;
• Plasmaphoresis - purification of blood plasma from antibodies and autoimmune complexes.

The treatment period is at least 3 months, then a second examination is carried out.

In order for the lupus anticoagulant values to return to normal, you should not smoke, abuse alcohol, eat fatty foods, and take unnecessary medications. It is important to reduce excess body weight. It is undesirable to eat foods that provoke blood clots: prunes, herbs, broccoli and cabbage, dried apricots, baked potatoes.

To reduce the density of blood and stimulate blood flow, it is important to intensively engage in physical education: swim in the pool, jog, walk, gymnastics.

If VA is detected in the blood, patients should be treated under the supervision of a cardiologist, hematologist, hemostasiologist. When planning pregnancy in women with an increased risk of thrombosis, it is important to regularly analyze the level of lupus anticoagulant and coagulogram indicators. The same studies are carried out from the first days of pregnancy, repeating until the very birth. If necessary, they undergo a stationary course of Heparin therapy.

Video about Lupus Anticoagulant and APS in Pregnancy:

The author of the article: Shutov Maxim Evgenievich | Hematologist

Education: In 2013 he graduated from the Kursk State Medical University and received a diploma "General Medicine". After 2 years, completed residency in the specialty "Oncology". In 2016 completed postgraduate studies at the National Medical and Surgical Center named after N. I. Pirogov.