Obstetric antiphospholipid syndrome

Abstract

Antiphospholipid syndrome (APS) is the most frequent acquired thrombophilia of autoimmune basis. Pregnancy complications of APS may include recurrent miscarriage, and placental dysfunction presenting as fetal death, prematurity, intrauterine growth restriction and preeclampsia. For the management of obstetric APS, a coordinated medical-obstetric management is essential, and this should start for a preconceptional visit in order to estimate the individual risk for complications, adjust therapies and establish the indications for preconceptional and first-trimester therapy. The basis of APS therapy during pregnancy is low-dose aspirin, combined in certain clinical scenarios with low-molecular weight heparin. Induction of delivery should not be routinely indicated in the absence of maternal and/or fetal complications. Postpartum management should be warranted.

Keywords: Aborto; Anticardiolipin; Anticardiolipina; Anticoagulante lúpico; Anticuerpos antifosfolípido; Antiphospholipid antibodies; Aspirina; Fetal loss; Heparin; Heparina; Hidroxicloroquina; Hydroxychloroquine; Low-dose aspirin; Lupus anticoagulant; Miscarriage; Muerte fetal; Preeclampsia.