Controversies concerning the antiphospholipid syndrome in obstetrics.
Antiphospholipid antibody syndrome is a non-inflammatory autoimmune disease characterized by recurrent thrombotic events and/or obstetric complications associated with the presence of circulating antiphospholipid antibodies (anticardiolipin antibodies, anti-β2glycoprotein-i antibodies, and/or lupus anticoagulant. Antiphospholipid antibodies are a heterogeneous group of autoantibodies associated with recurrent miscarriage, stillbirth, fetal growth restriction and premature birth. The diversity of the features of the proposed placental antiphospholipid antibodies fingerprint suggests that several disease processes may occur in the placentae of women with antiphospholipid antibody syndrome in the form of immune responses: inflammatory events, complement activation, angiogenic imbalance and, less commonly, thrombosis and infarction. Because of the disparity between clinical and laboratory criteria, and the impact on perinatal outcome in patients starting treatment, we reviewed the aspects of antiphospholipid antibody syndrome related to obstetric complications and seronegative antiphospholipid antibody syndrome, and their treatment in obstetrics.
Servicio de Medicina Materno Fetal, Instituto Nacional de Perinatología, Ciudad de México, México. Electronic address: dulce.camarena@inper.mx.
Dulce María Albertina
DM
Camarena Cabrera
Servicio de Medicina Materno Fetal, Instituto Nacional de Perinatología, Ciudad de México, México.
Claudia
C
Rodriguez-Jaimes
Servicio de Medicina Materno Fetal, Instituto Nacional de Perinatología, Ciudad de México, México.
Sandra
S
Acevedo-Gallegos
Servicio de Medicina Materno Fetal, Instituto Nacional de Perinatología, Ciudad de México, México.
Juan Manuel
JM
Gallardo-Gaona
Servicio de Medicina Materno Fetal, Instituto Nacional de Perinatología, Ciudad de México, México.
Berenice
B
Velazquez-Torres
Servicio de Medicina Materno Fetal, Instituto Nacional de Perinatología, Ciudad de México, México.
José Antonio
JA
Ramírez-Calvo
D016736:Antiphospholipid Syndrome / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy
Adverse perinatal outcome; Anticuerpos antifosfilipídicos; Antiphospholipid antibodies; Antiphospholipid antibody syndrome; Obstetric antiphospholipid syndrome; Resultados perinatales adversos; Seronegative antiphospholipid syndrome; Síndrome de anticuerpos antifosfolipídicos; Síndrome de anticuerpos antifosfolipídicos obstétrico; Síndrome de anticuerpos antifosfolipídicos seronegativo