How to reverse severe midtrimester oligohydramnios secondary to non-criteria obstetricantiphospholipid syndrome: a case report

Abstract

Abstract Background: Obstetrical antiphospholipid syndrome (OAPS) is an acquired autoimmune disorder characterized by recurrent pregnancy complications, which was orchestrated by elevated antiphospholipid (aPL) antibodies. The diagnosis of definite OAPS requires the presence of one or more typical clinical criteria and persistent aPL antibodies at least 12 weeks apart. However, the classification criteria for OAPS have generated wide debate, with a growing impression that certain patients not fully meeting these criteria might be inappropriately excluded from the classification, which is known as “non-criteria” OAPS. Case presentation: We reported here one unique cases of “non-criteria” OAPS, complicating severer midtrimester oligohydramnios. This patient has a history of a morphologically normal fetal loss, and the presence of intermittent aPLs (<12 weeks apart). Severe oligohydramnios was detected at the pregnancy of 22 weeks, and intrauterine growth restriction occurred latter. She was treated by TNF-α blockers in combination of low dose aspirin (LDA) plus low molecular weight heparin (LMWH), and delivered a healthy baby at the pregnancy of 37 weeks. No complications were observed in the mother and child during the follow-up period of ten months. Conclusion: TNF-α blockers in combination of LAD and LMWH appears to be a promising treatment for refractory obstetric complaints related to aPL.