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Prospective study of perinatal outcome in pregnancies with primary antiphospholipid syndrome
Insights
Antiphospholipid syndrome in pregnancy can lead to adverse outcomes, but early treatment with aspirin and low-molecular-weight heparin improves the chances of a healthy baby. Careful monitoring is key for successful pregnancy management.
Area of Science:
- Obstetrics and Gynecology
- Immunology
- Perinatal Medicine
Background:
- Antiphospholipid syndrome (APS) significantly increases risks of perinatal mortality and morbidity.
- Primary APS pregnancies require specialized management to mitigate adverse outcomes.
Purpose of the Study:
- To evaluate the perinatal outcomes in pregnancies diagnosed with primary antiphospholipid syndrome.
- To assess the efficacy of combined aspirin and low-molecular-weight heparin treatment in APS pregnancies.
Main Methods:
- Prospective study of 25 pregnant women with primary antiphospholipid syndrome.
- Treatment regimen included low-molecular-weight heparin and aspirin post-vital pregnancy establishment.
- Perinatal outcomes assessed included miscarriage rates, preterm delivery, live births, and neonatal complications.
Main Results:
- 80% of pregnancies resulted in live births; 12% miscarried, and 8% were stillbirths.
- Prematurity occurred in 20% of live births, with 20% experiencing intrauterine growth restriction.
- Adverse outcomes were strongly linked to anticardiolipin IgG antibodies and pregnancy-induced hypertension.
Conclusions:
- Early intervention with aspirin and low-molecular-weight heparin can improve perinatal outcomes in APS pregnancies.
- Meticulous fetomaternal monitoring is crucial for managing these high-risk pregnancies.
- A favorable perinatal outcome is achievable despite the inherent risks associated with primary antiphospholipid syndrome.
Background/Aim:
Pregnancies complicated with antiphospholipd syndrome are associated with the increased perinatal mortality and morbidity. The aim of this study was to assess perinatal outcome in pregnancies with primary antiphospholipd syndrome.
Methods:
This prospective study evaluated perinatal outcome in 25 pregnant women with antiphospholipid syndrome. After establishing vital pregnancy all the patients were treated with low-molecular-weight heparin and aspirin. The perinatal outcome was measured by rates of miscarriages, preterm deliveries, live births and neonatal complications.
Results:
Of the 25 pregnancies, 20 (80%) resulted in live birth, 3 (12%) in spontaneous abortion and 2 (8%) were stillbirths. The mean gestational age at delivery was 37.2 +/- 1.0 weeks, mean neonatal birth weight was 2,930.4 +/- 428.0 g. Prematurity occurs in 4 (20%) live births, and there were 4 (20%) intrauterine growth restriction with mean birth weight 2,060 +/- 210.6 g. Neonatal complications were present in 6 (3%) newborns. Adverse perinatal outcome was significantly associated with anticardiolipin IgG antibodies (p < 0.01) and development of hypertension during pregnancy (p < 0.01).
Conclusion:
Despite a high incidence of adverse perinatal outcomes in pregnancies with primary antiphospholipid syndrome, early treatment with aspirin and low-molecular-weight heparin, combined with meticulous fetomaternal monitoring could be associated with a relatively high probability of favorable perinatal outcome.
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