Recurrent fetal loss with circulating lupus anticoagulant: report of 2 cases.

Lupus anticoagulant (LAC), an autoantibody, in maternal circulation is responsible for a high incidence of fetal loss. We record 2 cases of recurrent fetal loss in association with LAC. The presence of LAC was diagnosed by prolonged activated partial thromboplastin time (aPTT), but was not correctable by dilution with normal plasma. During their subsequent pregnancies, these two women were treated with prednisolone and a low dose of aspirin (100 mg/day). Normal values of aPTT were achieved in both cases after treatment. Preeclampsia developed in one of the women, and a live premature infant was delivered by cesarean section. However, a successful term pregnancy was achieved in the other case. Corticosteroid and low-dose aspirin appear to improve fetal outcome in cases with LAC.