A study of sixty pregnancies in patients with the antiphospholipid syndrome

Clin Exp Rheumatol. Mar-Apr 1996;14(2):131-6.

Abstract

Objective: To study the maternal and fetal outcome in treated antiphospholipid syndrome (APS) pregnancies.

Methods: Sixty pregnancies in 47 APS patients (11 primary and 36 secondary) were followed in a multidisciplinary clinic. Patients testing antiphospholipid antibody positive and having a history of recurrent miscarriages were treated with low-dose aspirin (75 mg) daily. Patients with APS and a previous history of thrombotic events were treated with subcutaneous unfractionated or low molecular weight heparin and low-dose aspirin (75 mg) daily.

Results: The live birth rate increased from 19% of their previous non-treated pregnancies to 70% despite a high incidence of obstetric and fetal complications: pre-eclampsia (18%), prematurity (43%), fetal distress (50%) and intrauterine growth retardation (31%). Two predictors of fetal outcome were observed: the previous obstetric history and the presence of thrombocytopenia. Seven pregnancies (12%) were complicated by thrombotic events during pregnancy or during the puerperium. There were no thrombotic events in those receiving a low molecular weight heparin regimen.

Conclusion: Close obstetric monitoring by a multidisciplinary team and the use of antithrombotic therapy was effective in reducing the fetal wastage in APS pregnancies despite a high incidence of obstetric and fetal complications.

MeSH terms

  • Abortion, Habitual / complications
  • Abortion, Habitual / drug therapy
  • Adult
  • Antiphospholipid Syndrome / complications
  • Antiphospholipid Syndrome / physiopathology*
  • Aspirin / therapeutic use
  • Female
  • Heparin / therapeutic use
  • Heparin, Low-Molecular-Weight / therapeutic use
  • Humans
  • Medical Records
  • Pregnancy
  • Pregnancy Complications*
  • Pregnancy Complications, Hematologic
  • Pregnancy Outcome
  • Thrombocytopenia / complications
  • Thrombosis / complications
  • Thrombosis / drug therapy

Substances

  • Heparin, Low-Molecular-Weight
  • Heparin
  • Aspirin