ANTIPHOSPHOLIPID SYNDROME AND PREGNANCY

Abstract

The main issues of etiopathogenesis, clinical manifestations, diagnosis of antiphospholipid syndrome are considered. This syndrome is a state of the body whereat a thrombosis can occur, especially during pregnancy. This syndrome pathogenesis is characterized with an interaction of antiphospholipid antibodies with negatively charged phospholipids. They are the part of membranes of platelets, endotheliocytes, prothrombin−activating complex, beta−2−glycoprotein and nerve cells with impaired functions. Joining to phospholipids, the antiphospholipid antibodies lead to a sharp decrease in platelet count and impaired endothelial cell function. In nerve tissue disorders according to the structural and functional type occur, the formation and function of the humoral agents responsible for hemostasis are disrupted. The antiphospholipid syndrome in obstetrics and gynecology often manifests as spontaneous miscarriages, the effect of the "empty fetal egg", fetal growth retardation and even its antenatal death, as well as preeclampsia. In the treatment of pregnant women with antiphospholipid syndrome, mainly several protocols have been used, i.e. anticoagulants and antiplatelet agents in combination with glucocorticoids; combination of glucocorticoids with acetylsalicylic acid; monotherapy with sodium heparin or acetylsalicylic acid; anticoagulants and antiplatelet agents for hemostasis correction. The treatment protocols during pregnancy, childbirth and postpartum period have been presented. It is emphasized that the patients with antiphospholipid syndrome and vascular thrombosis should be monitored by rheumatologist, surgeon, obstetrician and gynecologist after successful child delivery. Duration of receiving antiplatelet and anticoagulant therapy has to be solved individually. Key words: antiphospholipid syndrome, antiphospholipid antibodies, cardiolipin antibodies, lupus anticoagulant, pregnancy, postpartum period.