title: Lupus and the antiphospholipid syndrome in pregnancy and obstetrics: clinical characteristics, diagnosis, pathogenesis, and treatment.
abstract: The antiphospholipid syndrome (APS) in pregnancy is associated with repeated miscarriages and fetal loss. Other complications of pregnancy such as preeclampsia and placental insufficiency are also frequently reported during pregnancy in APS. The pathogenesis of pregnancy failures in APS is related to both the thrombophilic effect of antiphospholipid antibodies and also to different mechanisms including a direct effect of antibodies on trophoblast differentiation and invasion. Although optimal pharmacologic treatment is essential to achieve a successful outcome in APS pregnancy, the standard APS pharmacologic treatment alone may not be sufficient. A good obstetric outcome is the result of careful obstetric monitoring, proper delivery timing, and skillful neonatal care. A multidisciplinary team (obstetricians, rheumatologists, and neonatologists) and the progress in neonatal intensive care are as important as drugs in achieving a good obstetric outcome and to reduce the possible consequences of premature delivery.
authors: Rheumatology and Clinical Immunology, University of Brescia, Brescia, Italy. tincani@bresciareumatologia.it
authors: Angela
authors: A
authors: Tincani
authors: Chiara
authors: C
authors: Bazzani
authors: Stefania
authors: S
authors: Zingarelli
authors: Andrea
authors: A
authors: Lojacono
mesh_terms: D000026:Abortion, Habitual / Q000209:etiology* / Q000276:immunology / Q000517:prevention & control; D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000276:immunology*; D000925:Anticoagulants / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000175:diagnosis / Q000209:etiology / Q000276:immunology*; D005260:Female; D005317:Fetal Growth Retardation / Q000209:etiology; D017359:HELLP Syndrome / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007231:Infant, Newborn; D016682:Lupus Coagulation Inhibitor; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000276:immunology; D010920:Placenta / Q000473:pathology; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D011256:Pregnancy Outcome; D019851:Thrombophilia / Q000188:drug therapy / Q000209:etiology; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control; D014327:Trophoblasts / Q000276:immunology
chemical_list: D017152:Antibodies, Antiphospholipid; D000925:Anticoagulants; D007166:Immunosuppressive Agents; D016682:Lupus Coagulation Inhibitor