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Obstetric antiphospholipid syndrome — SCE Rheumatology MCQ

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HardPregnancy and Rare Rheumatic DiseaseObstetric antiphospholipid syndromeSCE Rheumatology

A woman with criteria obstetric APS, no previous thrombosis, receives aspirin and prophylactic LMWH throughout pregnancy. Delivery is uncomplicated. What thromboprophylaxis plan should be discussed for the puerperium?

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Correct answer: A — Continue prophylactic LMWH for 6 weeks postpartum, then reassess thrombosis risk

Explanation lettering: D = shown as A · E = shown as B · B = shown as C · A = shown as D · C = shown as E

D is correct. EULAR advises considering continuation of the prophylactic heparin dose for six weeks postpartum because puerperal thrombosis risk remains increased. A and C stop too early. B and E convert obstetric APS without thrombosis into indefinite therapeutic anticoagulation. Warfarin can be used when therapeutic anticoagulation is indicated, but that indication is absent here.

Reference: EULAR recommendations for management of antiphospholipid syndrome: https://ard.bmj.com/content/78/10/1296