This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Granger, K. Articles by Farquharson, R. Search for Related Content PubMed PubMed Citation Articles by Granger, K. Articles by Farquharson, R. Social Bookmarking                         What's this?

Review : Obstetric outcome in antiphospholipid syndrome

Liverpool Women's Hospital, Crown Street, Liverpool L8 7SS, UK

RG Farquharson

Liverpool Women's Hospital, Crown Street, Liverpool L8 7SS, UK

The presence of lupus anticoagulant (LA) and anticardiolipin antibodies (ACA) are associated with recurring pregnancy loss. Of 387 consecutive patients investigated at a Recurring Miscarriage Clinic over a three year period, 63 (16%) were positive for LA and ACA or both. Fifty-nine patients by definition were classified as having antiphospholipid syndrome and four also had systemic lupus erythematosus (SLE). Fifty-three subsequent pregnancies occurred in 63 patients and of these 37 ended in a live birth giving an overall livebirth rate of 70%

Treatment included low dose aspirin alone in 37 pregnancies and low dose aspirin and low molecular weight heparin (L11WH) in 16 pregnancies. The decision for treatment was made empirically on past obstetric history and level of LA and ACA, and past history of venous thromboembolic disease. Obstetric outcome was worst in the group who were positive for both LA and ACA, with a success rate of 53%, compared to 72 or 81% in the single parameter groups. Complications in the 37 successful pregnancies included eight Caesarean sections, four cases of intra-uterine growth restriction, one case of pregnancy induced proteinuric hypertension, one deep vein thrombosis and one pulmonary embolism. Patients with antiphospholipid syndrome are at high risk of pregnancy loss as well as maternal morbidity, especially thrombo-embolic disease. A randomised prospective controlled trial is necessary to determine the optimum therapy for pregnancy conservation and thrombprophylaxis.

Key Words: antiphospholipid syndrome • anticardiolipin antibodies • lupus anticoagulant • obstetric outcome

Lupus, Vol. 6, No. 6, 509-513 (1997)
DOI: 10.1177/096120339700600606


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				I. A. Greer and C. Nelson-Piercy Low-molecular-weight heparins for thromboprophylaxis and treatment of venous thromboembolism in pregnancy: a systematic review of safety and efficacy Blood, July 15, 2005; 106(2): 401 - 407. [Abstract] [Full Text] [PDF]

				R. L. Bick and D. Hoppensteadt Recurrent Miscarriage Syndrome and Infertility Due to Blood Coagulation Protein/Platelet Defects: A Review and Update Clinical and Applied Thrombosis/Hemostasis, January 1, 2005; 11(1): 1 - 13. [Abstract] [PDF]

				O. M.H. Habayeb and J. C. Konje The one-stop recurrent miscarriage clinic: an evaluation of its effectiveness and outcome Hum. Reprod., December 1, 2004; 19(12): 2952 - 2958. [Abstract] [Full Text] [PDF]

				R Cervera and J Balasch The management of pregnant patients with antiphospholipid syndrome Lupus, September 1, 2004; 13(9): 683 - 687. [Abstract] [PDF]

				A.J. Carlin, R.G. Farquharson, S.M. Quenby, J. Topping, and W.D. Fraser Prospective observational study of bone mineral density during pregnancy: low molecular weight heparin versus control Hum. Reprod., May 1, 2004; 19(5): 1211 - 1214. [Abstract] [Full Text] [PDF]

				L. Heilmann, G.-F. v. Tempelhoff, and K. Pollow Antiphospholipid Syndrome in Obstetrics Clinical and Applied Thrombosis/Hemostasis, April 1, 2003; 9(2): 143 - 150. [Abstract] [PDF]

				J Balasch and R Cervera Reflections on the management of reproductive failure in the antiphospholipid syndrome--the clinician's perspective Lupus, August 1, 2002; 11(8): 467 - 477. [Abstract] [PDF]

				G Ruiz-Irastorza, M A Khamashta, and G R. Hughes Antiaggregant and anticoagulant therapy in systemic lupus erythematosus and Hughes' syndrome Lupus, March 1, 2001; 10(3): 241 - 245. [Abstract] [PDF]

				R. L. Bick Recurrent Miscarriage Syndrome due to Blood Coagulation Protein/Platelet Defects: Prevalence, Treatment and Outcome Results Clinical and Applied Thrombosis/Hemostasis, July 1, 2000; 6(3): 115 - 125. [Abstract] [PDF]