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  • Title: Primary antiphospholipid syndrome: pregnancy outcome in a portuguese population.
    Author: Serrano F, Nogueira I, Borges A, Branco J.
    Journal: Acta Reumatol Port; 2009; 34(3):492-7. PubMed ID: 19820673.
    Abstract:
    INTRODUCTION: Women with antiphospholipid syndrome (APS) may suffer from recurrent miscarriage, fetal death, fetal growth restriction (FGR), pre-eclampsia, placental abruption, premature delivery and thrombosis. Treatment with aspirin and low molecular weight heparin (LMWH) combined with close maternal-fetal surveillance can change these outcomes. OBJECTIVE: To assess maternal and perinatal outcome in a cohort of Portuguese women with primary APS. PATIENTS AND METHODS: A retrospective analysis of 51 women with primary APS followed in our institution (January 1994 to December 2007). Forty one (80.4%) had past pregnancy morbidity and 35.3% (n=18) suffered previous thrombotic events. In their past they had a total of 116 pregnancies of which only 13.79 % resulted in live births. Forty four patients had positive anticardiolipin antibodies and 33 lupus anticoagulant. All women received treatment with low dose aspirin and LMWH. RESULTS: There were a total of 67 gestations (66 single and one multiple). The live birth rate was 85.1% (57/67) with 10 pregnancy failures: seven in the first and second trimesters, one late fetal death and two medical terminations of pregnancy (one APS related). Mean (+/- SD) birth weight was 2837 +/- 812 g and mean gestational age 37 +/- 3.3 weeks. There were nine cases of FGR and 13 hypertensive complications (4 HELLP syndromes). 54.4% of the patients delivered by caesarean section. CONCLUSIONS: In our cohort, early treatment with aspirin and LMWH combined with close maternal--fetal surveillance was associated with a very high chance of a live newborn.
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