Prevention of miscarriage in antiphospholipid syndrome.
Recurrent adverse pregnancy outcome may be the final result of different causes, including autoimmune diseases, as the Antiphospholipid Syndrome. Antiphospholipid antibodies (lupus anticoagulant and/or anticardiolipin antibodies) were found in 16% of 197 patients with prior unexplained recurrent miscarriages. During our study 22 out of 32 antiphospholipid antibodies positive women became pregnant again. To prevent abortion relapses, 16 of them were treated with acetylsalicylic acid (50 mg x 2/day) and/or fluocortolone (20 mg/day for 5 days/week). Such therapy started as soon as pregnancy was diagnosed in 14 patients. Two patients began the therapeutic regimen during the third month of gestation. Six patients, who didn't accept this therapeutic approach, represent our control group. All the 14 early treated patients ended pregnancy with success. The 2 women that began the therapy later presented abortion relapses. Among the 6 not treated patients, 5 presented spontaneous abortion and only one gave birth to a baby. No side effect was observed neither in treated mothers nor in their babies. In conclusion, even if further studies would be necessary to standardise a therapeutic protocol, our results encourage the clinical care of patients with antiphospholipid antibodies and adverse pregnancy outcomes.
Passaleva
A
A
Clinica Medica III, University of Florence, Italy.
Massai
G
G
D'Elios
M M
MM
Livi
C
C
Abbate
R
R
D000026:Abortion, Habitual / Q000209:etiology / Q000276:immunology / Q000517:prevention & control*; D000328:Adult; D017153:Antibodies, Anticardiolipin / Q000276:immunology*; D016736:Antiphospholipid Syndrome / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D001241:Aspirin / Q000627:therapeutic use*; D005260:Female; D005313:Fetal Death / Q000209:etiology / Q000276:immunology / Q000517:prevention & control*; D005448:Fluocortolone / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D016682:Lupus Coagulation Inhibitor / Q000276:immunology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D011256:Pregnancy Outcome
D017153:Antibodies, Anticardiolipin; D016682:Lupus Coagulation Inhibitor; D005448:Fluocortolone; D001241:Aspirin