title: [Antiphospholipid syndrome and pregnancy: Obstetrical prognosis according to the type of APS].
abstract: OBJECTIVE
  The objective of our study was to compare treatment-based obstetrical outcomes in women with either thrombotic or obstetrical antiphospholipid syndrome (APS).
  
  
  METHODS
  This was a historical cohort study conducted between 1998 and 2009 in 23 patients who had a total of 83 pregnancies. The syndrome was diagnosed using the 2006 Sapporo criteria.
  
  
  RESULTS
  Thirty-one of these 83 pregnancies were valid before the diagnosis was made. A live infant was born in 22% of them, the infant being small for gestational age in 26% of cases. The fetus died in utero in a further 26% of cases. Pregnancies were subdivided into 2 groups depending on whether the initial event leading to APS diagnosis was obstetrical or thrombotic. Treatment (aspirin and low molecular weight heparin) was based on this classification: the latter was given in a curative dose for thrombotic events, in a preventive dose for obstetrical events. No fetal loss was observed when treatment was administered according to the protocol. Nevertheless, 20% of the pregnancies with obstetrical APS were complicated by smallness for gestational age and only 38% of the infants were live births. More than 87% of the thrombotic forms treated were free of complications and led to birth of a living child.
  
  
  CONCLUSIONS
  Appropriate treatment appears to improve the prognosis for pregnancies in patients with APS. These patients are nevertheless at increased risk of an obstetrical event and require close monitoring, especially in obstetrical manifestations, which appear to have a poorer prognosis. Multidisciplinary follow-up by an experienced team is essential.
authors.affiliation: Service et département de gynécologie-obstétrique et médecine de la reproduction, pôle femme-enfant, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France; Université de Caen Basse Normandie, Esplanade de la paix, 14032 Caen cedex 5, France. Electronic address: delesalle-c@chu-caen.fr.
authors.forename: C
authors.initials: C
authors.lastname: Delesalle
authors.affiliation: Service et département de gynécologie-obstétrique et médecine de la reproduction, pôle femme-enfant, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France.
authors.forename: C
authors.initials: C
authors.lastname: de Vienne
authors.affiliation: Département de médecine vasculaire, CHU de Caen, 14000 Caen, France.
authors.forename: C
authors.initials: C
authors.lastname: Le Hello
authors.affiliation: Pôle gynécologique et obstétrical, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen, France; Université de Rouen, 22, boulevard Gambetta, 76000 Rouen, France.
authors.forename: E
authors.initials: E
authors.lastname: Verspyck
authors.affiliation: Service et département de gynécologie-obstétrique et médecine de la reproduction, pôle femme-enfant, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France; Université de Caen Basse Normandie, Esplanade de la paix, 14032 Caen cedex 5, France.
authors.forename: M
authors.initials: M
authors.lastname: Dreyfus
mesh_terms: D000328:Adult; D016736:Antiphospholipid Syndrome / Q000145:classification* / Q000175:diagnosis* / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000453:epidemiology; D011256:Pregnancy Outcome / Q000453:epidemiology; D011379:Prognosis; D055815:Young Adult
keywords: Antiphospholipid syndrome; Grossesse; Management; Pregnancy; Syndrome des anticorps antiphospholipides; Traitement