Abstract
Aim: To evaluate the safety and efficacy of intralipid infusion in addition to other lines of treatment in reduction of complications caused by antiphospholipid antibody syndrome. Methods: This study was held in the period from June 1, 2016, to December 1, 2019. This study was conducted in the Department of Obstetrics and Gynecology, Tanta University on patients attending the antenatal care clinic and also on patients attending the researcher’s private clinics for antenatal care, 105 patients were enrolled after application of strict inclusion and exclusion criteria. They were randomized into 2 groups. In group A (study group 1) the patients received in addition to the conventional basic treatment of APS, intralipid 20% (Frezenius, Clayton, NC, USA) in a dose of 4 ml diluted in 250 ml 0.9% regular saline IV and to be repeated every 2 weeks. In group B (control group 2) the patients received the conventional basic treatment of APS. The outcome measures were the incidence of pregnancy complications of APS namely fetal loss, premature delivery, IUGR and preeclampsia. Results: 49 patients were enrolled in the study group, and 48 patients were enrolled in the control group, after exclusion of the skipped cases. The demographic data and the gestational age at the beginning of the study show insignificant differences. There were insignificant differences as regard the gestational age at which the pregnancy was terminated and fetal birth weight in patients with positive ACL test, positive LA test and positive B2 however the mean gestational age at which pregnancy was terminated was higher in study group. Also, there was insignificant difference as regards no of patients who complicated with abortion or who completed to full term. But had significant decrease number of case who complicated with preeclampsia (8, 21 patients in study and control group respectively). Conclusion: Intralipid infusion is a promising treatment option for control and prevention of problems caused by antiphospholipid antibody syndrome.
Highlights
The origin of antiphospholipid syndrome (APS) begins with the recognition of Wasserman’s antibody, which was used to detect the presence of Treponema pallidum and found to bind the phospholipid cardiolipin [1]
There were insignificant differences as regard the gestational age at which the pregnancy was terminated and fetal birth weight in patients with positive ACL test, positive lupus anticoagulant (LA) test and positive B2 the mean gestational age at which pregnancy was terminated was higher in study group
The aim of this paper is to evaluate the safety and efficacy of intralipid infusion in addition to other lines of treatment in reduction of complications caused by antiphospholipid antibody syndrome
Summary
The origin of antiphospholipid syndrome (APS) begins with the recognition of Wasserman’s antibody, which was used to detect the presence of Treponema pallidum and found to bind the phospholipid cardiolipin [1]. After that the antibody was found in non syphilitic patients, indicating low specificity of this test and so a new term, biologic false positive serologic test for syphilis (BFP-STS), originates. In the 1950s, the BFP-STS was associated with another factor that causes inhibition of coagulation termed the lupus anticoagulant (LA) [2]. The in vitro studies revealed that APL produces a pro-coagulant state and thrombosis at the placental level through several postulated mechanisms, which had been disconfirmed by later studies, and by histopathological examination of the placentas taken from APS women complicated by miscarriage [4]. Even Some researchers have postulated that obstetric APS is an inflammatory disorder [5], but even with these postulations, the evidence of inflammation isn’t found in all laboratory animals or in all immunohistological analysis of placentae from APS patients [4]
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