Anesthetic Care for Pregnant Women With Antiphospholipid Antibody Syndrome Undergoing LSCS

Antiphospholipid antibody syndrome (APS) is an autoimmune disorder that causes a hypercoagulable state due to antiphospholipid antibodies. These antibodies target phospholipids, causing vascular thrombosis, which can result in recurrent fetal loss and other systemic complications in pregnant women. APS syndrome can be primary or secondary, with the former being more common and of unknown origin. Secondary APS syndrome is linked to other autoimmune disorders, like systemic lupus erythematosus. In rare cases, APLA can lead to catastrophic antiphospholipid syndrome (CAPS or Asherson syndrome), which is characterized by rapid organ failure due to generalized thrombosis and a high mortality rate. Treatment with anticoagulant medication is typically necessary to reduce the risk of thrombosis and improve pregnancy outcomes. However, surgery in these patients poses a higher risk of thrombosis due to the discontinuation of anticoagulants and the increased risk of bleeding. Therefore, a multidisciplinary approach involving anesthesiologists, obstetricians, pediatricians, and rheumatologists is necessary to improve maternal and fetal outcomes. In this case report, we detail the careful anesthesiologic management of a pregnant woman with APS syndrome to ensure a safe delivery. This involved preoperative treatment with LMWH, fasting guidelines, and risk consent. During the surgery, a ner spinal needle was used to reduce the risk of spinal hematoma, and thromboprophylaxis and early mobilization were performed. Regular follow-up examinations were conducted to monitor the patient's condition.