Professional and Linguistic Assessments Board (PLAB) Practice Exam

What is the recommended treatment for anti-phospholipid syndrome in pregnancy?

1. Corticosteroids

2. LMWH and aspirin

3. Heparin only

4. Oral anticoagulants

The correct answer is: LMWH and aspirin

The recommended treatment for anti-phospholipid syndrome in pregnancy is the combination of low molecular weight heparin (LMWH) and aspirin. This treatment approach is well-supported by clinical guidelines and research, as it aims to reduce the risk of pregnancy complications associated with this syndrome, such as thrombosis and fetal loss. Anti-phospholipid syndrome is associated with an increased tendency towards clotting, which poses significant risks during pregnancy. Aspirin has anti-platelet effects, while LMWH helps in preventing venous thromboembolism by inhibiting the coagulation cascade. Together, they effectively lower the risk of both maternal and fetal complications in pregnant women with this condition. The other treatment choices do not provide the same level of effectiveness or safety during pregnancy. Corticosteroids are typically used in cases where there is significant inflammatory activity or other autoimmune components, but they do not directly manage the thrombogenic risks associated with anti-phospholipid syndrome. Heparin alone would not be sufficient as it does not have the antiplatelet effects of aspirin, and using oral anticoagulants poses risks, especially in early pregnancy, due to their potential effects on fetal development. Hence, the combination of LMWH and aspirin is the standard recommendation