Lupus and the antiphospholipid syndrome in pregnancy and obstetrics: clinical characteristics, diagnosis, pathogenesis, and treatment

Semin Thromb Hemost. 2008 Apr;34(3):267-73. doi: 10.1055/s-0028-1082270.


The antiphospholipid syndrome (APS) in pregnancy is associated with repeated miscarriages and fetal loss. Other complications of pregnancy such as preeclampsia and placental insufficiency are also frequently reported during pregnancy in APS. The pathogenesis of pregnancy failures in APS is related to both the thrombophilic effect of antiphospholipid antibodies and also to different mechanisms including a direct effect of antibodies on trophoblast differentiation and invasion. Although optimal pharmacologic treatment is essential to achieve a successful outcome in APS pregnancy, the standard APS pharmacologic treatment alone may not be sufficient. A good obstetric outcome is the result of careful obstetric monitoring, proper delivery timing, and skillful neonatal care. A multidisciplinary team (obstetricians, rheumatologists, and neonatologists) and the progress in neonatal intensive care are as important as drugs in achieving a good obstetric outcome and to reduce the possible consequences of premature delivery.

Publication types

  • Review

MeSH terms

  • Abortion, Habitual / etiology*
  • Abortion, Habitual / immunology
  • Abortion, Habitual / prevention & control
  • Adult
  • Antibodies, Antiphospholipid / immunology*
  • Anticoagulants / therapeutic use
  • Antiphospholipid Syndrome / diagnosis
  • Antiphospholipid Syndrome / etiology
  • Antiphospholipid Syndrome / immunology*
  • Female
  • Fetal Growth Retardation / etiology
  • HELLP Syndrome / immunology
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Infant, Newborn
  • Lupus Coagulation Inhibitor
  • Lupus Erythematosus, Systemic / complications*
  • Lupus Erythematosus, Systemic / immunology
  • Placenta / pathology
  • Pregnancy
  • Pregnancy Complications, Hematologic / diagnosis
  • Pregnancy Complications, Hematologic / drug therapy
  • Pregnancy Complications, Hematologic / immunology*
  • Pregnancy Outcome
  • Thrombophilia / drug therapy
  • Thrombophilia / etiology
  • Thrombosis / etiology
  • Thrombosis / prevention & control
  • Trophoblasts / immunology


  • Antibodies, Antiphospholipid
  • Anticoagulants
  • Immunosuppressive Agents
  • Lupus Coagulation Inhibitor