Plasmapheresis and pregnancy outcome in patients with antiphospholipid syndrome.
OBJECTIVE
To assess plasmapheresis with low dose prednisone on obstetric and neonatal outcomes among unsuccessfully treated pregnant women with documented antiphospholipid syndrome (APS).


METHODS
Eighteen pregnant women received prednisone (10 mg/day) and plasmapheresis at 7.08+/-0.6 weeks of gestation, for 3 sessions per week, until lupus anticoagulant activity suppressed and IgG anticardiolipin lowered. Serial pulsatility indexes (PI) of umbilical and uterine arteries were performed.


RESULTS
The live birth rate was 100%; mild pre-eclampsia 5.5%; preterm deliveries 22.22%; intrauterine growth restriction 11.11%; thrombocytopenia 5.5%; oligohydramnios and fetal distress 16.6%. There were no perinatal deaths, thrombotic events or lupus flare. Uterine artery PI was reduced and umbilical artery PI was >95th percentile.


CONCLUSIONS
Plasmapheresis and low dose prednisone were associated with a low rate of obstetric and neonatal complications. Plasmapheresis may be used to treat pregnant women with documented APS when first lines (aspirin and/or heparin) fail to prevent pregnancy loss.
El-Haieg
D O
DO
Gynecology and Obstetrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt. drdalia65@hotmail.com
Zanati
M F
MF
El-Foual
F M
FM
D000026:Abortion, Habitual / Q000628:therapy*; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000628:therapy*; D005260:Female; D006801:Humans; D050498:Live Birth; D010865:Pilot Projects; D010956:Plasmapheresis; D011241:Prednisone / Q000627:therapeutic use; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000628:therapy*; D011673:Pulsatile Flow
D000893:Anti-Inflammatory Agents; D011241:Prednisone