Antiphospohlipid syndrome in obstetrics

TY - JOUR

T1 - Antiphospohlipid syndrome in obstetrics

AU - Danza, Alvaro

AU - Ruiz-Irastorza, Guillermo

AU - Khamashta, Munther

PY - 2012/2

Y1 - 2012/2

N2 - Antiphospholipid syndrome is characterised by a variety of clinical and immunological manifestations. The clinical hallmarks of this syndrome are thrombosis and poor obstetric outcomes, including miscarriages, fetal loss and severe pre-eclampsia. The main antiphospholipid antibodies include lupus anticoagulant, anticardiolipin and anti-beta 2-glycoprotein 1. The combination of aspirin and heparin is considered the standard of care for women with antiphospholipid syndrome and embryo-fetal losses: however, aspirin in monotherapy may have a place in women with recurrent early miscarriage. A good benefit-risk ratio of low-molecular-weight heparin in pregnancy thrombosis treatment has been reported. Warfarin must be avoided if possible throughout the first trimester of pregnancy. Adequate pregnancy management of women with antiphospholipid syndrome should include coordinated medical-obstetrical care, a close follow-up protocol and a good neonatal unit. Close blood pressure control and early detection of proteinuria, together with Doppler studies of the utero-placental circulation should be included in the management protocol. (C) 2011 Elsevier Ltd. All rights reserved.

AB - Antiphospholipid syndrome is characterised by a variety of clinical and immunological manifestations. The clinical hallmarks of this syndrome are thrombosis and poor obstetric outcomes, including miscarriages, fetal loss and severe pre-eclampsia. The main antiphospholipid antibodies include lupus anticoagulant, anticardiolipin and anti-beta 2-glycoprotein 1. The combination of aspirin and heparin is considered the standard of care for women with antiphospholipid syndrome and embryo-fetal losses: however, aspirin in monotherapy may have a place in women with recurrent early miscarriage. A good benefit-risk ratio of low-molecular-weight heparin in pregnancy thrombosis treatment has been reported. Warfarin must be avoided if possible throughout the first trimester of pregnancy. Adequate pregnancy management of women with antiphospholipid syndrome should include coordinated medical-obstetrical care, a close follow-up protocol and a good neonatal unit. Close blood pressure control and early detection of proteinuria, together with Doppler studies of the utero-placental circulation should be included in the management protocol. (C) 2011 Elsevier Ltd. All rights reserved.

U2 - 10.1016/j.bpobgyn.2011.10.006

DO - 10.1016/j.bpobgyn.2011.10.006

M3 - Article

VL - 26

SP - 65

EP - 76

JO - Best Practice & Research Clinical Obstetrics & Gynaecology

JF - Best Practice & Research Clinical Obstetrics & Gynaecology

IS - 1

ER -