Abstract
Background: The 20-30% of women with antiphospholipid syndrome (APS) remains unable to give birth to healthy neonates despite the conventional treatment. The purpose of this review is to summarize literature on the predictors of poor pregnancy outcome in women affected by APS. Results: History of pregnancy morbidity and/or thrombosis and the association with SLE are well known historybased predictive factors for pregnancy failure in women with APS. Moreover, laboratory findings associated with unsuccessful pregnancy outcome are lupus anticoagulant positivity, triple antiphospholipid antibodies (aPL) positivity, false-positive IgM for CMV and hypocomplementemia. The abnormal uterine arteries Doppler velocimetry results are confirmed to be strongly associated with poor maternal and feto-neonatal outcomes in APS pregnancies. Conclusion: To correctly explore and identify these clinical and laboratory variables associated with pregnancy failure is a critical step in aiding clinicians to manage and counsel the women with APS. Finding the optimal combination therapy according to these risk factors to prevent the main maternal and feto-neonatal complications in APS pregnancies is warranted.
Highlights
Prognosis of pregnancies in women with Antiphospholipid Syndrome (APS) has greatly improved over the past two decades
To correctly explore and identify these clinical and laboratory variables associated with pregnancy failure is a critical step in aiding clinicians to manage and counsel the women with antiphospholipid syndrome (APS)
Finding the optimal combination therapy according to these risk factors to prevent the main maternal and feto-neonatal complications in APS pregnancies is warranted
Summary
Prognosis of pregnancies in women with Antiphospholipid Syndrome (APS) has greatly improved over the past two decades. Conventional treatment based on low molecular weight heparin (LMWH) and low-dose aspirin (LDA) is associated with a rate of live birth of almost 80% [1,2,3]. Despite these encouraging results, some APS patients remain unable to give birth to healthy neonates. Some pregnancies may be complicated by preeclampsia, fetal growth restriction (FGR) and pre-term birth. The 20-30% of women with antiphospholipid syndrome (APS) remains unable to give birth to healthy neonates despite the conventional treatment.
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