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Journal of Obstrectic Anaesthesia and Critical Care
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CASE REPORT
Year : 2022  |  Volume : 12  |  Issue : 1  |  Page : 67-69

Spinal anaesthesia, a special consideration in antiphospholipid antibody syndrome in pregnancy: A case series


Department of Anaesthesiology, IMS and SUM Hospital, SOA Deemed to be University, Bhubaneswar, Odisha, India

Correspondence Address:
Dr. Soumya Samal
Department of Anaesthesiology, IMS and SUM Hospital, SOA Deemed to be University, Bhubaneswar - 751 003, Odisha
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JOACC.JOACC_74_21

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Antiphospholipid syndrome (APLA) is an acquired autoimmune disorder, clinically characterised by the development of thrombosis and obstetric morbidities comprising recurrent miscarriages, fetal deaths and premature births resulting from placental insufficiency such as intrauterine growth restriction and pre-eclampsia. It is the most common acquired hypercoagulable state where the focus of management is anticoagulation for the prevention of thrombosis.We report three cases of primary APLA syndrome in parturients at term with history of multiple abortions, being managed with oral aspirin and low molecular weight heparin posted for elective caesarian section. All three parturients were given single shot atraumatic spinal anaesthesia achieving a level of sensory blockade up to T6 since their coagulation profile showed no abnormalities. Antiphospholipid-antibody syndrome requires a multidisciplinary approach during pregnancy where use of anticoagulants may lead to dilemma of their perioperative continuation. Discontinuation of anticoagulants is a double-edged sword requiring careful deliberation on the part of anaesthetist to reduce the risk of perioperative bleeding.


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