title: Predictors of pregnancy outcome in antiphospholipid syndrome: a review.
abstract: In pregnant women, antiphospholipid syndrome (APS) is associated with an increased risk of preeclampsia, fetal intrauterine growth restriction, and other complications related to uteroplacental insufficiency. In the last two decades, several studies were performed to identify the predictive role of some parameters in relation to obstetric outcome in APS patients. Among these, the uterine velocimetry Doppler is the most studied. It provides a non-invasive method for the study of uteroplacental blood flow, being able to detect a condition of impaired placental perfusion, due to the presence of circulating antiphospholipid antibodies (aPL). To date, the uterine artery Doppler velocimetry resulted to be a useful tool to identify APS pregnancies at higher risk of adverse pregnancy outcome. False-positive IgM for toxoplasmosis, others, rubella, cytomegalovirus, herpes viruses (TORCH) complex is associated to a worse pregnancy outcome because it reflects a dysregulation of the immune system which may amplify placental autoimmune damage. Moreover low levels of complement components are related to an increased incidence of obstetrical complications, suggesting that placental deposition of immune complexes and activation of complement cascade may contribute to placental failure APS related. The abnormal uterine Doppler velocimetry, false-positive TORCH IgM and low levels of complement components can be considered prognostic indexes of poor pregnancy outcome in APS.
authors: Department of Obstetrics and Gynecology, Catholic University of Sacred Hearth, Rome, Italy. saradecarolis@libero.it
authors: Sara
authors: S
authors: De Carolis
authors: Angela
authors: A
authors: Botta
authors: Stefania
authors: S
authors: Santucci
authors: Serafina
authors: S
authors: Garofalo
authors: Carmelinda
authors: C
authors: Martino
authors: Alessandra
authors: A
authors: Perrelli
authors: Silvia
authors: S
authors: Salvi
authors: Sergio
authors: S
authors: Ferrazzani
authors: Leonardo
authors: L
authors: Caforio
authors: Giovanni
authors: G
authors: Scambia
mesh_terms: D016736:Antiphospholipid Syndrome / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000503:physiopathology*; D011256:Pregnancy Outcome