title: Additional Treatments for High-Risk Obstetric Antiphospholipid Syndrome: a Comprehensive Review.
abstract: Most investigators currently advocate prophylactic-dose heparin plus low-dose aspirin as the preferred treatment of otherwise healthy women with obstetric antiphospholipid syndrome, whilst women with a history of vascular thrombosis alone or associated with pregnancy morbidity are usually treated with therapeutic heparin doses in association with low-dose aspirin in an attempt to prevent both thrombosis and pregnancy morbidity. However, the protocols outlined above fail in about 20 % of pregnant women with antiphospholipid syndrome. Identifying risk factors associated with pregnancy failure when conventional therapies are utilized is an important step in establishing guidelines to manage these high-risk patients. Some clinical and laboratory risk factors have been found to be related to maternal-foetal complications in pregnant women on conventional therapy. However, the most efficacious treatments to administer to high-risk antiphospholipid syndrome women in addition to conventional therapy in order to avoid pregnancy complications are as yet unestablished. This is a comprehensive review on this topic and an invitation to participate in a multicentre study in order to identify the best additional treatments to be used in this subset of antiphospholipid syndrome patients.
authors.affiliation: Rheumatology Unit, Department of Medicine, University of Padua, Padua, Italy. amelia.ruffatti@unipd.it.|Reumatologia, Policlinico Universitario, Via Giustiniani, 2-35128, Padova, Italy. amelia.ruffatti@unipd.it.
authors.forename: Amelia
authors.initials: A
authors.lastname: Ruffatti
authors.affiliation: Rheumatology Unit, Department of Medicine, University of Padua, Padua, Italy.
authors.forename: Ariela
authors.initials: A
authors.lastname: Hoxha
authors.affiliation: Rheumatology Unit, Department of Medicine, University of Padua, Padua, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Favaro
authors.affiliation: Rheumatology Unit, Department of Medicine, University of Padua, Padua, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Tonello
authors.affiliation: Blood Transfusion Unit, University-Hospital of Padua, Padua, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Colpo
authors.affiliation: Cardiology Unit, Department of Cardio-Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Cucchini
authors.affiliation: Cardiology Unit, Department of Cardio-Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Banzato
authors.affiliation: Cardiology Unit, Department of Cardio-Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Pengo
mesh_terms: D016736:Antiphospholipid Syndrome / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000628:therapy*; D011256:Pregnancy Outcome; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D016756:Immunoglobulins, Intravenous
keywords: Additional treatment; Obstetric antiphospholipid syndrome; Risk factor; Treatment