title: Antiphospholipid Syndrome during pregnancy: the state of the art.
abstract: Obstetric complications are the hallmark of antiphospholipid syndrome. Recurrent miscarriage, early delivery, oligohydramnios, prematurity, intrauterine growth restriction, fetal distress, fetal or neonatal thrombosis, pre-eclampsia/eclampsia, HELLP syndrome, arterial or venous thrombosis and placental insufficiency are the most severe APS-related complication for pregnant women. Antiphospholipid antibodies promote activation of endothelial cells, monocytes and platelets, causing an overproduction of tissue factor and thromboxane A2. Complement activation might have a central pathogenetic role. These factors, associated with the typical changes in the hemostatic system during normal pregnancy, result in a hypercoagulable state. This is responsible of thrombosis that is presumed to provoke many of the pregnancy complications associated with APS. Obstetric care is based on combined medical-obstetric high-risk management and treatment with the association between aspirin and heparin. This review aims to deter- mine the current state of the art of APS by investigating the knowledge achievements of recent years, to provide the most appropriate diagnostic and therapeutic management for pregnant women suffering from this syndrome.
authors.affiliation: Policlinico Hospital, Department of Obstetrics and Gynecology, University of Catania, Italy.
authors.forename: Fosca A F
authors.initials: FA
authors.lastname: Di Prima
authors.forename: Oriana
authors.initials: O
authors.lastname: Valenti
authors.forename: Entela
authors.initials: E
authors.lastname: Hyseni
authors.forename: Elsa
authors.initials: E
authors.lastname: Giorgio
authors.forename: Marianna
authors.initials: M
authors.lastname: Faraci
authors.forename: Eliana
authors.initials: E
authors.lastname: Renda
authors.forename: Roberta
authors.initials: R
authors.lastname: De Domenico
authors.forename: Santo
authors.initials: S
authors.lastname: Monte