title: Management of obstetric antiphospholipid syndrome.
abstract: Recurrent early miscarriages (excluding chromosomal anomalies), late fetal loss, and maternal thrombosis are characteristic of obstetric antiphospholipid syndrome (APS). Obstetric complications such as preeclampsia, fetal growth restriction, premature delivery, and fetal death also occur in higher frequency in APS patients than in the general population. A high-risk obstetric center is needed for proper evaluation of and intervention with pregnant women with APS. Association with lupus carries additional risk of thrombosis when antiphospholipid antibodies (aPLs) are present. Gestational results with live births are improved to about 80% when antithrombotic therapy is used, but failure in 20% to 30% of the cases despite correct treatment with low-dose aspirin with or without heparin reveals new pathways for pregnancy loss in APS and unmet needs. At the moment, there is no recommendation to investigate patients with infertility for the presence of aPLs.
authors: Department of Obstetrics, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil. guilhermedejesus@gmail.com
authors: Guilherme Ribeiro Ramires
authors: GR
authors: de Jesus
authors: Flavia Cunha
authors: FC
authors: dos Santos
authors: Camila Souto
authors: CS
authors: Oliveira
authors: Wallace
authors: W
authors: Mendes-Silva
authors: Nilson Ramires
authors: NR
authors: de Jesus
authors: Roger Abramino
authors: RA
authors: Levy
mesh_terms: D016736:Antiphospholipid Syndrome / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications