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Case | Reference | Sex | Delivery and newborn age | Clinical manifestation | Maternal history | Neonatal antibodies | Treatment | Evolution |
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1 | Finazzi et al. 1987 [4] | F | Preeclampsia cesarean delivery/20 days | Cyanosis in the left foot. US Doppler: left femoral artery thrombosis | Primary APS | Lupus anticoagulant | NR | Death on day 30 due to extensive aortic thrombus (autopsy) |
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2 | Sheridan-Pereira et al. 1988 [5] | F | Cesarean delivery/at birth | DIC and MV. Absence of distal pulses and cyanosis. Thrombosis of the aorta at the origin of the superior mesenteric artery 32 hours after birth. Central catheter used | Maternal APS | Lupus anticoagulant | Plasmapheresis and heparin | The peripheral pulses were normal on day 13 |
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3 | Silver et al. 1992 [6] | NR | Delivery NR/at birth | Right spastic hemiparesis. MRI: middle cerebral artery infarction | Mother with multiple sclerosis and primary APS | NR | NR | Improvement of the hemiparesis at 6 months |
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4 | Contractor et al. 1992 [7] | NR | Cesarean delivery/1 day | Left abdominal mass and hematuria. Renal vein and inferior vena cava thrombosis | Mother with aPL | IgG anti-cardiolipin | NR | Clinical improvement at day 7. The antiphospholipid profile disappeared at 4 months postpartum |
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5 | Tabbutt et al. 1994 [8] | M | Cesarean delivery/3 days | Aortic, left renal artery, middle cerebral and superior sagittal sinus thrombosis, sepsis | Primary APS | Prolonged APTT, aPL negative | Heparin and ATB | Favorable at 2 months |
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6 | Hage et al. 1994 [9] | M | Cesarean delivery/at birth | Hydrops fetalis with renal vein thrombosis | Healthy mother | Lupus anticoagulant | Mother was treated with tocolytic medications | Unfavorable. Fetal death |
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7 | Teyssier et al. 1995 [10] | M | Normal vaginal delivery/3 days | Convulsion due to cerebrovascular ischemia and massive bilateral adrenal hemorrhage | Mother with aPL | Anti-cardiolipin positive | Phenobarbital | Favorable. Normal EEG at 7 months after birth |
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8 |
de Klerk et al. 1997 [11] | M | Normal vaginal delivery/at birth | Seizures, blinking repeatedly, spasms on the right side of the head, hand, and foot (no longer than 3 minutes). Ischemic stroke at the level of the left middle cerebral artery | Mother with aPL | Lupus anticoagulant | Phenobarbital | Favorable after 1 year |
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9 | Navarro et al. 1997 [12] | NR | Cesarean delivery/3 days | Respiratory distress syndrome, pneumoperitoneum and abdominal livedo (mesenteric thrombosis) | Primary APS | IgG anti-cardiolipin | NR | Death on day 11 after laparotomy |
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10 | Akanli et al. 1998 [13] | NR | Cesarean delivery/6 hours | Apnea, cyanosis, and moderate hypotonia. Mechanical ventilation. Progressed with stroke in the left middle cerebral artery area | Mother with aPL | IgG anti-cardiolipin | NR | Seizures until 3 years of age |
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11 |
Chow and Mellor 2000 [14] | F | Cesarean delivery/48 hours | Focal seizure in the left hemibody. CT: cerebral ischemia | Primary APS | IgG anti-cardiolipin | Phenobarbital and phenytoin | Favorable. Normal neurological examination 5 months after birth |
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12 | Chow and Mellor 2000 [14] | M | Delivery NR/at birth | Right hemiplegia; later developed epilepsy. CT: ischemia at the level of the left middle cerebral artery | Primary APS | NR | NR | Unfavorable. Epilepsy |
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13 |
Tuohy and Harrison 2005 [15] | M | Preeclampsia, cesarean delivery/5 days | Anuria, paleness, and absence of pulse in the lower extremities. Aortic thrombosis | Primary APS | IgG anti-cardiolipin | rTPA | Death from renal failure on day 10 |
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14 | Soares Rolim et al. 2006 [1] | M | Delivery NR/20 hours | Thrombocytopenia, livedo reticularis; pericardial effusion; subclavian vein and external jugular thrombosis concomitantly with severe respiratory tract/central catheter infection | Secondary APS | IgG and IgM anti-cardiolipin | Immunoglobulin IV heparin and antibiotic treatment | Death |
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15 | Paro-Panjan et al. 2007 [16] | F | Normal vaginal delivery/13 hours | Seizures; ischemic stroke. MRI: occlusion of the left middle cerebral artery | Mother with aPL | IgG anti-cardiolipin. Mutation of the prothrombin gene polymorphism G20210A and gene polymorphism C677T | Phenobarbital | No neurological deficits after 1 year of follow-up |
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16 | Alshekaili et al. 2010 [17] | M | Normal vaginal delivery/5 days | Reduced spontaneous movement of the right limbs; ischemic stroke of the middle cerebral artery. Epilepsy. Late livedo reticularis (after 4 years) | Healthy mother | IgG anti-cardiolipin, IgG anti B2GPI. Factor V Leiden (G20210A allele) | Antiepileptic and anticoagulant | Favorable |
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17 | Cabral et al. 2011 [18] | M | Normal vaginal delivery/17 days | Irritability, abdominal distension, vomiting, bloody stools with signs of shock, necrotizing enteritis-exploratory laparotomy. ICC: after 13 months, started to exhibit tonic-clonic seizures and right hemiparesis. Stroke in the frontal, parietal, and right temporal lobes | Healthy mother | Lupus anticoagulant, IgG/IgM anti-cardiolipin, IgG and IgM anti-B2GPI. PT polymorphism 20210G>A and PAI-1 polymorphism 675G>A | Low molecular weight heparin, acetyl salicylic acid, and phenobarbital | Favorable after 5 years of follow-up |
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18 | Bhat et al. 2011 [19] | M | Cesarean delivery/3 days | Sepsis. Bluish discoloration in the left lower limb (thrombosis of the left femoral artery); absence of popliteal pulse and prolonged capillary refill time | Mother with aPL | Lupus anticoagulant | Thrombolysis, urokinase/heparin, and antibiotic | Favorable |
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19 | De Carolis et al. 2012 [20] | M | Normal vaginal delivery/1 day | Severe respiratory distress due to pneumonia. Thrombosis in the superior sagittal sinus | Healthy mother | IgG anti-cardiolipin | NR | Normal neurological development after 1 year |
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20 | Merlin et al. 2012 [21] | M | Normal vaginal delivery/3 days | Right clonic seizures. MRI showed left middle cerebral artery infarction | Healthy mother | IgG anti-cardiolipin and IgG B2GPI | 100 mg of valproate and aspirin every other day | Normal development and neurological examination after 1 year |
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21 | Sousa et al. 2012 [22] | F | Cesarean delivery/8 hours | Focal and multifocal seizures and left hemiparesis. MRI: ischemic stroke | Healthy mother | IgG anti-cardiolipin, IgG B2GPI, and lupus anticoagulant positives (de novo synthesis). 1298C/C MTHFR and PAI-1 844A/A and 675 4G/4G gene polymorphisms | Anticonvulsants and aspirin | L side body strength improved and monoparesis in the left upper limb persisted after 1 year. Seizures improved at 3 months of age |
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