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Clin Exp Rheumatol. 1996 Mar-Apr;14(2):131-6.

A study of sixty pregnancies in patients with the antiphospholipid syndrome.

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  • 1Lupus Pregnancy Clinic, St. Thomas' Hospital, London, United Kingdom.

Abstract

OBJECTIVE:

To study the maternal and fetal outcome in treated antiphospholipid syndrome (APS) pregnancies.

METHODS:

Sixty pregnancies in 47 APS patients (11 primary and 36 secondary) were followed in a multidisciplinary clinic. Patients testing antiphospholipid antibody positive and having a history of recurrent miscarriages were treated with low-dose aspirin (75 mg) daily. Patients with APS and a previous history of thrombotic events were treated with subcutaneous unfractionated or low molecular weight heparin and low-dose aspirin (75 mg) daily.

RESULTS:

The live birth rate increased from 19% of their previous non-treated pregnancies to 70% despite a high incidence of obstetric and fetal complications: pre-eclampsia (18%), prematurity (43%), fetal distress (50%) and intrauterine growth retardation (31%). Two predictors of fetal outcome were observed: the previous obstetric history and the presence of thrombocytopenia. Seven pregnancies (12%) were complicated by thrombotic events during pregnancy or during the puerperium. There were no thrombotic events in those receiving a low molecular weight heparin regimen.

CONCLUSION:

Close obstetric monitoring by a multidisciplinary team and the use of antithrombotic therapy was effective in reducing the fetal wastage in APS pregnancies despite a high incidence of obstetric and fetal complications.

PMID:
8737718
[PubMed - indexed for MEDLINE]
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