Pregnancy loss and antiphospholipid antibodies.
With the use of low-dose heparin, fetal survival of aPL pregnancies is 70-80%, but prematurity and intrauterine growth restriction are common. It is likely, but not proven, that dysregulated placental coagulation and resultant vasculopathy are the cause of fetal loss. Details of dysregulated coagulation remain to be described. Opportunities remain to determine the role of coagulopathy in repeated pregnancy loss, identify a critical event or window to which intervention might be directed, identify maternal (and fetal) characteristics other than aPL that determine fetal loss, describe toxicity profiles of current treatments, develop more specific, less toxic therapies, and describe long-term fetal and maternal outcomes.
Lockshin
M D
MD
Barbara Volcker Center for Women and Rheumatic Disease, Hospital for Special Surgery, Cornell Medical Center, New York, NY 10021, USA.
D000026:Abortion, Habitual / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology / Q000503:physiopathology / Q000517:prevention & control; D000818:Animals; D017152:Antibodies, Antiphospholipid / Q000276:immunology*; D000925:Anticoagulants / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000453:epidemiology / Q000276:immunology; D001327:Autoimmune Diseases / Q000150:complications* / Q000453:epidemiology / Q000276:immunology; D004195:Disease Models, Animal; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000276:immunology; D010920:Placenta / Q000276:immunology; D010956:Plasmapheresis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000276:immunology*; D011256:Pregnancy Outcome; D012306:Risk
D017152:Antibodies, Antiphospholipid; D000925:Anticoagulants; D007166:Immunosuppressive Agents; D006493:Heparin