title: Antiphospohlipid syndrome in obstetrics.
abstract: Antiphospholipid syndrome is characterised by a variety of clinical and immunological manifestations. The clinical hallmarks of this syndrome are thrombosis and poor obstetric outcomes, including miscarriages, fetal loss and severe pre-eclampsia. The main antiphospholipid antibodies include lupus anticoagulant, anticardiolipin and anti-β2-glycoprotein I. The combination of aspirin and heparin is considered the standard of care for women with antiphospholipid syndrome and embryo-fetal losses; however, aspirin in monotherapy may have a place in women with recurrent early miscarriage. A good benefit-risk ratio of low-molecular-weight heparin in pregnancy thrombosis treatment has been reported. Warfarin must be avoided if possible throughout the first trimester of pregnancy. Adequate pregnancy management of women with antiphospholipid syndrome should include co-ordinated medical-obstetrical care, a close follow-up protocol and a good neonatal unit. Close blood pressure control and early detection of proteinuria, together with Doppler studies of the utero-placental circulation should be included in the management protocol.
authors.affiliation: Autoimmune Diseases Research Unit, Department of Internal Medicine, Hospital Universitario Cruces, University of the Basque Country, Bizkaia, Spain.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Danza
authors.forename: Guillermo
authors.initials: G
authors.lastname: Ruiz-Irastorza
authors.forename: Munther
authors.initials: M
authors.lastname: Khamashta
mesh_terms: D016736:Antiphospholipid Syndrome / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000188:drug therapy / Q000209:etiology; D011225:Pre-Eclampsia / Q000188:drug therapy / Q000209:etiology; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000175:diagnosis* / Q000188:drug therapy*; D013927:Thrombosis / Q000188:drug therapy / Q000209:etiology