OBJECTIVE: To study the maternal and fetal outcome in treated antiphospholipid syndrome (APS) pregnancies. METHODS: Sixty pregnancies in 47 APS patients (11 primary and 36 secondary) were followed in a multidisciplinary clinic. Patients testing antiphospholipid antibody positive and having a history of recurrent miscarriages were treated with low-dose aspirin (75 mg) daily. Patients with APS and a previous history of thrombotic events were treated with subcutaneous unfractionated or low molecular weight heparin and low-dose aspirin (75 mg) daily. RESULTS: The live birth rate increased from 19% of their previous non-treated pregnancies to 70% despite a high incidence of obstetric and fetal complications: pre-eclampsia (18%), prematurity (43%), fetal distress (50%) and intrauterine growth retardation (31%). Two predictors of fetal outcome were observed: the previous obstetric history and the presence of thrombocytopenia. Seven pregnancies (12%) were complicated by thrombotic events during pregnancy or during the puerperium. There were no thrombotic events in those receiving a low molecular weight heparin regimen. CONCLUSION: Close obstetric monitoring by a multidisciplinary team and the use of antithrombotic therapy was effective in reducing the fetal wastage in APS pregnancies despite a high incidence of obstetric and fetal complications.
OBJECTIVE: To study the maternal and fetal outcome in treated antiphospholipid syndrome (APS) pregnancies. METHODS: Sixty pregnancies in 47 APSpatients (11 primary and 36 secondary) were followed in a multidisciplinary clinic. Patients testing antiphospholipid antibody positive and having a history of recurrent miscarriages were treated with low-dose aspirin (75 mg) daily. Patients with APS and a previous history of thrombotic events were treated with subcutaneous unfractionated or low molecular weight heparin and low-dose aspirin (75 mg) daily. RESULTS: The live birth rate increased from 19% of their previous non-treated pregnancies to 70% despite a high incidence of obstetric and fetal complications: pre-eclampsia (18%), prematurity (43%), fetal distress (50%) and intrauterine growth retardation (31%). Two predictors of fetal outcome were observed: the previous obstetric history and the presence of thrombocytopenia. Seven pregnancies (12%) were complicated by thrombotic events during pregnancy or during the puerperium. There were no thrombotic events in those receiving a low molecular weight heparin regimen. CONCLUSION: Close obstetric monitoring by a multidisciplinary team and the use of antithrombotic therapy was effective in reducing the fetal wastage in APS pregnancies despite a high incidence of obstetric and fetal complications.
Authors: Fosca A F Di Prima; Oriana Valenti; Entela Hyseni; Elsa Giorgio; Marianna Faraci; Eliana Renda; Roberta De Domenico; Santo Monte Journal: J Prenat Med Date: 2011-04