How would you approach a woman with APLA but no thrombosis/APLS, a history of ITP without bleeding who is now pregnant?  

As a rheumatologist, I would want to make sure this patient does not have SLE. If no suspicion for SLE (and no previous obstetric complications), I would mostly likely monitor closely during pregnancy without any additional interventions. 

I absolutely agree in making sure the patient does not have SLE. We know that across the board the presence of aPLs is a major risk factor for pregnancy loss as well as other adverse outcomes including things like pre-eclampsia and IUGR, especially in association with SLE. I would also make sur...