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Thrombotic APS in pregnancy — SCE Rheumatology MCQ

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HardPregnancy in rheumatic disease, rare conditionsThrombotic APS in pregnancySCE Rheumatology

A 26-year-old woman with SLE and previous unprovoked pulmonary embolism has persistent lupus anticoagulant. She is now 8 weeks pregnant and was taking warfarin before conception. What is the most appropriate management?

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Correct answer: B — Therapeutic LMWH plus low-dose aspirin

Pregnancy with thrombotic APS usually requires therapeutic-dose LMWH plus low-dose aspirin, with warfarin avoided in early pregnancy because of teratogenicity. Aspirin alone is inadequate for prior thrombosis. Specialist obstetric medicine and rheumatology input are essential.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/musculoskeletal-conditions