Primary antiphospholipid syndrome: pregnancy outcome in a portuguese population.
BACKGROUND
Women with antiphospholipid syndrome (APS) may suffer from recurrent miscarriage, fetal death, fetal growth restriction (FGR), pre-eclampsia, placental abruption, premature delivery and thrombosis. Treatment with aspirin and low molecular weight heparin (LMWH) combined with close maternal-fetal surveillance can change these outcomes.


OBJECTIVE
To assess maternal and perinatal outcome in a cohort of Portuguese women with primary APS.


METHODS
A retrospective analysis of 51 women with primary APS followed in our institution (January 1994 to December 2007). Forty one (80.4%) had past pregnancy morbidity and 35.3% (n=18) suffered previous thrombotic events. In their past they had a total of 116 pregnancies of which only 13.79 % resulted in live births. Forty four patients had positive anticardiolipin antibodies and 33 lupus anticoagulant. All women received treatment with low dose aspirin and LMWH.


RESULTS
There were a total of 67 gestations (66 single and one multiple). The live birth rate was 85.1% (57/67) with 10 pregnancy failures: seven in the first and second trimesters, one late fetal death and two medical terminations of pregnancy (one APS related). Mean (+/- SD) birth weight was 2837 +/- 812 g and mean gestational age 37 +/- 3.3 weeks. There were nine cases of FGR and 13 hypertensive complications (4 HELLP syndromes). 54.4% of the patients delivered by caesarean section.


CONCLUSIONS
In our cohort, early treatment with aspirin and LMWH combined with close maternal--fetal surveillance was associated with a very high chance of a live newborn.
Serrano
Fatima
F
Recurrent miscarriage Clinic, Department of Maternal and Fetal Medicine, Maternidade Dr. Alfredo da Costa. fatima_serrano@hotmail.com
Nogueira
Isabel
I
Borges
Augusta
A
Branco
Jorge
J
D000328:Adult; D016736:Antiphospholipid Syndrome / Q000628:therapy; D005260:Female; D006801:Humans; D011174:Portugal; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D055815:Young Adult