title: A study of sixty pregnancies in patients with the antiphospholipid syndrome.
abstract: 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.
  
  
  CONCLUSIONS
  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: Lupus Pregnancy Clinic, St. Thomas' Hospital, London, United Kingdom.
authors: F
authors: F
authors: Lima
authors: M A
authors: MA
authors: Khamashta
authors: N M
authors: NM
authors: Buchanan
authors: S
authors: S
authors: Kerslake
authors: B J
authors: BJ
authors: Hunt
authors: G R
authors: GR
authors: Hughes
mesh_terms: D000026:Abortion, Habitual / Q000150:complications / Q000188:drug therapy; D000328:Adult; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000503:physiopathology*; D001241:Aspirin / Q000627:therapeutic use; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D008499:Medical Records; D011247:Pregnancy; D011248:Pregnancy Complications; D011250:Pregnancy Complications, Hematologic; D011256:Pregnancy Outcome; D013921:Thrombocytopenia / Q000150:complications; D013927:Thrombosis / Q000150:complications / Q000188:drug therapy
chemical_list: D006495:Heparin, Low-Molecular-Weight; D006493:Heparin; D001241:Aspirin