Antiphospholipid syndrome in pregnancy: a diagnostic dilemma.

Objective: To present a case of severe pre-eclampsia in which diagnosis of the antiphospholipid syndrome was made after delivery, and to discuss pointers to the diagnosis.

Clinical Features: A 32-year-old woman in her second pregnancy presented at 32 weeks' gestation with severe pre-eclampsia. Her persisting severe postpartum illness was investigated. The presence of anticardiolipin antibodies and lupus anticoagulant led to the diagnosis of antiphospholipid syndrome.

Intervention And Outcome: Induction of labour was successful, with delivery of a healthy baby girl. The patient made a full recovery after treatment with corticosteroids and warfarin.

Conclusion: The antiphospholipid syndrome should be considered in cases of severe early pre-eclampsia.