Antiphospohlipid syndrome in obstetrics

Area of Science:

• Obstetrics and Gynecology
• Immunology
• Hematology

Background:

• Antiphospholipid syndrome (APS) presents with diverse clinical and immunological features.
• Key manifestations include thrombosis and adverse obstetric outcomes like miscarriage and pre-eclampsia.
• Diagnostic antiphospholipid antibodies include lupus anticoagulant, anticardiolipin, and anti-β2-glycoprotein I.

Purpose of the Study:

• To outline the management of antiphospholipid syndrome during pregnancy.
• To discuss therapeutic strategies for thrombosis and obstetric complications in APS patients.

Main Methods:

• Review of current literature and clinical guidelines for APS management in pregnancy.
• Analysis of treatment efficacy and safety profiles of anticoagulants and antiplatelet agents.

Main Results:

• Aspirin and heparin combination is the standard for APS with embryo-fetal loss.
• Aspirin monotherapy may be suitable for recurrent early miscarriage.
• Low-molecular-weight heparin shows a favorable benefit-risk ratio for pregnancy thrombosis.
• Warfarin use is discouraged during the first trimester.

Conclusions:

• Optimal APS pregnancy management requires coordinated medical-obstetrical care and close monitoring.
• Protocols should include vigilant blood pressure control, proteinuria detection, and Doppler studies.
• Specialized neonatal care is essential for affected pregnancies.