A literature review on the antiphospholipid syndrome and the effect on childbearing.
OBJECTIVE
to review the literature on antiphospholipid antibodies and their significance to midwifery practice.


METHODS
databases using the keywords anticardiolipin antibodies, antiphospholipid antibodies, lupus antibodies, antiphospholipid syndrome, systemic lupus erythematosis, pregnancy loss, pre-eclampsia were searched, 548 articles were generated and 52 were used in the review.


RESULTS
anticardiolipin antibodies are detrimental to successful pregnancy being implicated in failure of implantation, loss of the embryo and the fetus. There is also a risk of prematurity, intrauterine growth retardation and neonatal embolism. The risks to the mother are of pre-eclampsia and embolic complications. If diagnosed and treated early in pregnancy with low-dose aspirin and subcutaneous heparin the outlook for a successful pregnancy is much improved.


CONCLUSIONS
much research remains to be undertaken. Researchers need to standardise their criteria so that findings are comparable and larger sample groups are necessary.


CONCLUSIONS
antiphospholipid syndrome is an important disorder and a preventable cause of pregnancy loss. Midwives need to encourage women to persevere with therapy to preserve pregnancy and maybe prevent pre-eclampsia or thrombosis. When pregnancies are lost one of the hardest things is when the parents cannot understand why. Midwives need to understand the syndrome to collaborate with doctors in explaining it and supporting grieving parents.
Vials
J M
JM
School of Nursing and Midwifery, University of Wolverhampton, Esk House, Dudley, West Midlands, DY1 2HQ.
D000925:Anticoagulants / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000175:diagnosis / Q000276:immunology / Q000628:therapy; D001241:Aspirin / Q000627:therapeutic use; D004617:Embolism / Q000209:etiology; D005260:Female; D005313:Fetal Death / Q000209:etiology; D005315:Fetal Diseases / Q000209:etiology; D005317:Fetal Growth Retardation / Q000209:etiology; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D016389:Maternal-Child Nursing / Q000379:methods; D009721:Nurse Midwives; D007752:Obstetric Labor, Premature / Q000209:etiology; D011225:Pre-Eclampsia / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000276:immunology / Q000628:therapy; D011256:Pregnancy Outcome / Q000453:epidemiology; D018566:Pregnancy, High-Risk; D012307:Risk Factors
D000925:Anticoagulants; D006493:Heparin; D001241:Aspirin