DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20213486

A case series on successful pregnancy outcomes in patients with Apla syndrome

Priyanka Gaur, Swati Kochar, Vaibhav Sharma

Abstract


The antiphospholipid antibody syndrome (APS) is defined by the persistent presence of antiphospholipid antibodies in patients with recurrent venous or arterial thromboembolism or pregnancy morbidity. Obstetric complications such as recurrent pregnancy loss, oligohydramnios, preterm delivery, fetal growth restriction, preeclampsia, HELLP syndrome and fetal distress are frequently associated with antiphospholipid syndrome. Successful management of pregnancies with APLA syndrome is a huge challenge for treating obstetrician. Obstetric care is based on combined medical and obstetric high risk management and treatment with the association between aspirin and heparin. Here, we present 3 cases of pregnancy with APLA syndrome who were successfully managed and they had uneventful pregnancies with successful outcomes without any complication.


Keywords


APLA syndrome, Aspirin, Heparin

Full Text:

PDF

References


Hughes GR. Thrombosis, abortion, cerebral disease and the lupus anticoagulant. BMJ. 1983;287:1088-9.

Asherson RA, Khamashta MA, Ordi-Ros J, Derksen RH, Machin SJ, Barquinero J, et al. The "primary" antiphospholipid syndrome: major clinical and serological features. Medicine (Baltimore).1989;68(6):366-74.

Jerzak M, Wozniak S, Kotarski J. Pregnancy outcome in the woman with antiphospholipid antibody. Geburt Shilfe Frauenheilkd. 1996;56(8):410-3.

Galli M, Barbui T. Prevalence of different antiphospholipid antibody in Systemic Lupus Erythematosus and their relationship with the Antiphospholipid Antibody Syndrome. Clinical Chemistry. 2001;47(6):985-7.

Miyakis S, Lockshin MD, Atsumi T. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost. 2006;4:295-306.

Rand JH, Wu XX, Andree HAM, Lockwood CJ, Guller S, Scher J, et al. Pregnancy loss in the antiphospholipid antibody syndrome-a possible thrombogenic mechanism. N Engl J Med. 1997;337:154-60.

Wilson A, Gharavi AE, Koike T. International consensus statement on preliminary classification criteria for definite antiphospholipid syndrome. Arthritis Rheum. 1999;42:1309-11.

Avcin T, Cimaz R, Meroni PL. Recent advances in antiphospholipid antibodies and antiphospholipid syndromes in pediatric populations. Lupus. 2002;11:4-10.

Branch DW, Khamashta MA. Antiphospholipid syndrome: obstetric diagnosis, management, and controversies. Obstet Gynecol. 2003;101:1333-44.

Harris EN, Spinnato JA. Should anticardiolipin tests be performed in otherwise healthy pregnant women? Am J Obstet Gynecol. 1991;165:1272-7.

Gris JC, Quire I, Monpeyroux F. Case-control study of the frequency of thrombophilic disorders in couples with late foetal loss and no thrombotic antecedent - the Nimes obstetricians and haematologists study 5 (NOHA 5). Thrombosis Haemostasis. 1999;81:891-9.

Heit JA, Kobbervig CE, James AH. Trends in the incidence of venous thromboembolism during pregnancy or postpartum: a 30-year population-based study. Ann Intern Med. 2005;143:697-706.

Bourjeily G, Paidas M, Khalil H. Pulmonary embolism in pregnancy. Lancet. 2009.

Bramham K, Hunt BJ, Germain S. Pregnancy outcome in different clinical phenotypes of antiphospholipid syndrome. Lupus. 2010;19:58-64.

Ruiz-Irastorza G, Khamashta MA. Lupus and pregnancy: ten questions and some answers. Lupus. 2008;17:416-20.

Bates SM, Greer IA, Pabinger I, Sofaer S, Hirsh J. Venous thromboembolism, thrombophilia, antithrombotic therapy, and pregnancy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th edn). Chest. 2008;133:844S-86S.

Carmona F, Font J, Azulay M. Risk factors associated with fetal losses in treated antiphospholipid syndrome pregnancies: a multivariate analysis. Am J Reprod Immunol. 2001;46:274-9.

Tincani A, Branch W, Levy RA. Treatment of pregnant patients with antiphospholipid syndrome. Lupus. 2003;12:524-9.

Rand J, Wu X, Quinn A, Chen P, Hathcock J, Taatjes D. Hydroxychloroquine directly reduces the binding of antiphospholipid antibody-β2-glycoprotein I complexes to phospholipid bilayers. Blood. 2008;112:1687-95.

The American College of Obstetricians and Gynecologists. Antiphospholipid Syndrome. ACOG Practice Bulletin. 2011;118:1-8.