De novo diagnosed antiphospholipid syndrome due to second trimester fetal bradycardia

Mothers known to have autoimmune diseases are at risk of delivering an affected infant with inborn defects such as congenital complete heart block, structural cardiac malformations. Antiphospholipid syndrome (APS) is an autoimmune disorder in which antiphospholipid antibodies (aPL) are thought to be involved in the development of venous and/or arterial thrombosis. Women with antiphospholipid antibodies have an unusually high proportion of pregnancy losses within the fetal period (10 or more weeks of gestation).
We report two cases of APS which are diagnosed in the second trimester, as a result of fetal bradycardia. Despite the patients had no symptoms related to systemic lupus erythematosus and even were not aware of their diseases, fetal bradycardia and the anamnesis of miscarriage seemed suggestive of circulating anticoagulants in maternal serum. Treatment was started with low molecular weight heparin, Nadroparine calcium (Fraxiparine flac.) 0.6 mi (15.000 ICU) / day and acetylsalicylic acid 80 mg/day. They both gave birth with cesarian sections to healthy babies at 35th and 37th week of gestations.
Fetal bradycardia appearing in the second trimester may be an indicator of antiphospholipid syndrome / circulating anticoagulants in maternal serum and deserves fetal-maternal investigation thus close monitorizing and treatment.

Anahtar Kelimeler

-