Preeclampsia and the Antiphospholipid Syndrome

Area of Science:

• Obstetrics and Gynecology
• Immunology
• Rheumatology

Background:

• Antiphospholipid syndrome (APS) involves thrombosis and pregnancy complications due to antiphospholipid antibodies (aPLs).
• Early onset preeclampsia (<34 weeks) is a clinical criterion for APS, sharing pathophysiology with defective trophoblast invasion.
• Women with APS face increased risks of prematurity, often linked to placental dysfunction like preeclampsia or fetal growth restriction (FGR).

Purpose of the Study:

• To review the association between Antiphospholipid Syndrome (APS) and pregnancy complications.
• To discuss current and potential therapeutic strategies for APS in pregnancy.
• To highlight the role of hydroxychloroquine (HCQ), vitamin D, and curcumin in managing APS during gestation.

Main Methods:

• Literature review on Antiphospholipid Syndrome (APS) and pregnancy outcomes.
• Analysis of the pathophysiology linking APS and preeclampsia.
• Evaluation of existing and emerging treatments for APS in pregnant individuals.

Main Results:

• Preeclampsia complicates 10-17% of APS pregnancies; early onset is a diagnostic criterion.
• Women with APS have higher rates of preterm delivery, even without preeclampsia or FGR.
• Standard treatment (aspirin, heparin) is insufficient for 20-30% of patients, necessitating further interventions.

Conclusions:

• Hydroxychloroquine (HCQ) is an effective additional treatment for APS in pregnancy.
• Nutritional interventions like vitamin D show promise for improving outcomes.
• Curcumin's antioxidant and anti-inflammatory properties suggest potential as an adjunctive therapy for APS during pregnancy.