[Antiphospholipid antibody syndrome in adverse pregnancy]

As a single test beta 2-glycoprotein I-dependent anticardiolipin antibody(beta 2GPI-dependent aCL) appears to be superior to cofactor-independent anticardiolipin antibody or any other single conventional antiphospholipid antibody for the detection of autoantibody-associated conditions of reproductive failure. beta 2GPI-dependent aCL are significantly highly associated with adverse pregnancy outcomes in healthy pregnant women and can be used for prediction, whereas beta 2GPI-independent aCL can not. Anticardiolipin antibodies and Lupus anticoagulant(LAC) define two distinct but partly related populations. LAC and anti beta 2GPI antibodies appear to be associated with pregnancy loss, with LAC being linked not only to spontaneous abortions in the first trimester but also to miscarriages in the second trimester. The live birth rate in patients strongly positive for antiphospholipid antibody(aPL) is lower than that in patients with moderate aPL production even if treatment with prednisolone, heparin, high-dose immunoglobulin, and/or low-dose aspirin is performed during pregnancy. However, low-dose aspirin is useful to treat cases of moderate aPL so that distinction between the two groups is warranted.