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Obstetric Anti-phospholipid Syndrome: State of the Art

  • Maria Chiara Gerardi
  • Melissa Alexandre Fernandes
  • Angela Tincani
  • Laura Andreoli
Antiphospholipid Syndrome (S Zuily, Section Editor)
  • 187 Downloads
Part of the following topical collections:
  1. Topical Collection on Antiphospholipid Syndrome

Abstract

Purpose of Review

This review focuses on new pathogenesis and clinical-therapeutic aspects of obstetric anti-phospholipid syndrome (ob-APS) in the last 5 years.

Recent Findings

The pathogenesis of ob-APS is multifactorial, including placental infarctions, infiltration of inflammatory cells that cause acute and chronic inflammation, leading to uncontrolled inflammation and poor pregnancy outcomes. A preconception counseling and a patient-tailored treatment are fundamental to improve maternal and fetal outcomes. Thanks to conventional treatment, based on low-dose aspirin and heparin, 70% of women with ob-APS can have successful pregnancies. Women with positive anti-phospholipid antibodies (aPL) without clinical manifestations (“aPL carriers”) or with obstetric manifestation not fulfilling ob-APS criteria need to be further investigated in order to assess their best management.

Summary

Great interest has been given to drugs that could interact in the pathophysiological mechanisms, such as hydroxychloroquine, statins, and eculizumab. These drugs could be considered for patients refractory to conventional therapy.

Keywords

Anti-phospholipid syndrome Anti-phospholipid antibodies Pregnancy morbidity Obstetric complications Pathogenesis Management Treatment 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Maria Chiara Gerardi
    • 1
  • Melissa Alexandre Fernandes
    • 2
  • Angela Tincani
    • 1
  • Laura Andreoli
    • 1
  1. 1.Rheumatology and Clinical Immunology Unit and Department of Clinical and Experimental SciencesSpedali Civili and University of BresciaBresciaItaly
  2. 2.Autoimmune Disease Unit—Department of Internal MedicineHospital Curry Cabral/Centro Hospitalar Lisboa CentralLisbonPortugal

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