Antiphospholipid antibodies and reproduction

Area of Science:

• Obstetrics and Gynecology
• Immunology
• Hematology

Background:

• Antiphospholipid antibodies (APAs) are associated with adverse obstetrical outcomes.
• Diagnostic methods for APAs include coagulation studies and solid-phase immunologic assays (ELISA; RIA).
• These assays may detect different antibodies, necessitating the use of both for comprehensive screening.

Purpose of the Study:

• To review the diagnostic approaches for antiphospholipid antibodies.
• To discuss the association of APAs with obstetrical complications.
• To explore potential treatment strategies for APA-associated conditions.

Main Methods:

• Review of laboratory diagnostic techniques for APAs, including Kaolin Clotting Time, ELISA, and RIA.
• Examination of clinical associations between APAs and obstetrical complications such as recurrent spontaneous abortion and preeclampsia.
• Analysis of preliminary treatment data for APA-associated conditions.

Main Results:

• The Kaolin Clotting Time is sensitive for lupus anticoagulant detection.
• Solid-phase assays for anticardiolipin antibodies may be more sensitive and predictive of clinical outcomes.
• Preliminary data suggest prednisone and aspirin improve viable infant delivery rates.

Conclusions:

• Comprehensive APA screening using both coagulation and solid-phase assays is recommended.
• APA detection is crucial for managing obstetrical complications.
• Further prospective trials are needed to confirm treatment efficacy, but initial results for prednisone and aspirin are promising.