title: Pregnancy morbidity in antiphospholipid syndrome: what is the impact of treatment?
abstract: Women with persistently circulating antiphospholipid antibodies (aPL) have a higher incidence of recurrent abortions, fetal losses, pre-eclampsia, and placental insufficiency. Current treatment of patients with antiphospholipid syndrome (APS) during pregnancy with heparin and aspirin can act by preventing clot formation and improving live birth rates, but other obstetric morbidities remain high, especially in patients with a history of thrombotic events. In addition to the classical thrombotic placental events, other factors involving inflammation and complement activation seem to play a role in certain complications. In this article, we will review how medications interfere in the pathogenic mechanisms of APS, discuss the impact of current recommended treatment on pregnancy morbidity, and analyze new promising therapies.
authors.affiliation: Department of Obstetrics, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil, guilhermedejesus@gmail.com.
authors.forename: Guilherme R
authors.initials: GR
authors.lastname: de Jesús
authors.forename: Gustavo
authors.initials: G
authors.lastname: Rodrigues
authors.forename: Nilson R
authors.initials: NR
authors.lastname: de Jesús
authors.forename: Roger A
authors.initials: RA
authors.lastname: Levy
mesh_terms: D000026:Abortion, Habitual / Q000209:etiology / Q000517:prevention & control; D000925:Anticoagulants / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000188:drug therapy*; D001241:Aspirin / Q000627:therapeutic use; D005260:Female; D005317:Fetal Growth Retardation / Q000209:etiology / Q000517:prevention & control; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use; D011225:Pre-Eclampsia / Q000209:etiology / Q000517:prevention & control; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011256:Pregnancy Outcome; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D006886:Hydroxychloroquine; D001241:Aspirin