Antiphospholipid antibody syndrome

Obstet Gynecol Clin North Am. 2014 Mar;41(1):113-32. doi: 10.1016/j.ogc.2013.10.004.

Abstract

Antiphospholipid antibodies (aPLs) are acquired antibodies directed against negatively charged phospholipids. Obstetric antiphospholipid antibody syndrome (APS) is diagnosed in the presence of certain clinical features in conjunction with positive laboratory findings. Obstetric APS is one of the most commonly identified causes of recurrent pregnancy loss. Thus, obstetric APS is distinguished from APS in other organ systems where the most common manifestation is thrombosis. Several pathophysiologic mechanisms of action of aPLs have been described. This article discusses the diagnostic and obstetric challenges of obstetric APS, proposed pathophysiologic mechanisms of APS during pregnancy, and the management of women during and after pregnancy.

Keywords: Antiphospholipid antibodies; Antiphospholipid syndrome; Complications of pregnancy; Fetal demise; Recurrent pregnancy loss; Unfractionated heparin.

Publication types

  • Review

MeSH terms

  • Abortion, Habitual / drug therapy
  • Abortion, Habitual / etiology
  • Abortion, Habitual / immunology*
  • Antibodies, Antiphospholipid / immunology*
  • Antiphospholipid Syndrome / complications
  • Antiphospholipid Syndrome / drug therapy
  • Antiphospholipid Syndrome / immunology*
  • Aspirin / therapeutic use
  • Female
  • Fibrinolytic Agents / therapeutic use
  • Heparin / therapeutic use
  • Humans
  • Placental Insufficiency / etiology
  • Placental Insufficiency / immunology*
  • Pregnancy
  • Pregnancy Complications / drug therapy
  • Pregnancy Complications / immunology*

Substances

  • Antibodies, Antiphospholipid
  • Fibrinolytic Agents
  • Heparin
  • Aspirin