RESEARCH ARTICLE


Obstetrical Considerations and Management of Antiphospholipid Syndrome



Karen J Gibbins*, Robert M Silver
Department of Obstetrics and Gynecology, University of Utah Health Sciences Center and Intermountain Healthcare, 30 N Medical Drive, Salt Lake City, UT 84132, USA


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© Gibbins and Silver; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Obstetrics and Gynecology, University of Utah Health Sciences Center and Intermountain Healthcare, 30 N Medical Drive, Salt Lake City, UT 84132, USA; Tel: 801-581-8425; Fax: 801-585-5146; E-mail karen.gibbins@hsc.utah.edu


Abstract

Antiphospholipid syndrome is a pro-thrombotic, pro-inflammatory condition defined by at least one clinical criterion and one laboratory finding. Clinical criteria are met by history of thrombosis or obstetric morbidity, including recurrent early pregnancy loss, fetal death, or delivery prior to 34 weeks gestation due to pre-eclampsia or placental insufficiency. Laboratory criteria are evidence of lupus anticoagulant or high titers of anticardiolipin or anti-β2-glycoprotein-I IgG or IgM. Treatment during pregnancy is primarily based on anticoagulant therapy, either at prophylactic or therapeutic doses depending on thrombosis history. This treatment certainly reduces thrombosis risk and may also improve obstetric outcome.

Keywords: Antiphospholipid syndrome, pre-eclampsia, pregnancy loss, stillbirth.