Antiphospholipid Syndrome Women Research Articles

The effect of lupus disease on the pregnant women and embryos: a retrospective study from 2010 to 2014.

Pregnancy in women with systemic lupus erythematosus (SLE) is one of the challenges of recent studies. Women should prevent the onset of relapses with medications before and after pregnancy, and on the other hand, the effect of these medicines considers the health and development of the fetus. In this retrospective study, the effects of anti-phospholipid syndrome and the use of common drugs such as methotrexate, cyclosporine, and azathioprine and their side effects on maternal health and ultimately the development of the fetus have been investigated. This study is a descriptive and retrospective epidemiologic study that was conducted in 2016 to investigate maternal and fetal complications in SLE patients. We prepared forms of data recording, including age, occupation, and other important information and then analyzed them in SPSS version 22. The results showed that the presence of anti-phospholipid syndrome in pregnant women can lead to abnormalities such as preterm, IUGR, abortion, and fetal death (P value 0.0001). It also leads to complications such as nephritis, arthritis, and preeclampsia in the mother (P value 0.003). This study suggests that methotrexate and cyclosporine medications could cause fetal developmental disorders. The P value of cyclosporine was 0.0001 and the P value of methotrexate was 0.001. Anti-phospholipid syndrome in women with SLE who intend to become pregnant can disrupt the development of the embryo. The consumption of methotrexate and cyclosporine medications before and during the pregnancy can have irreparable effects on fetal growth. Key Points • Anti-phospholipid syndrome can disrupt the development of the embryo in women with SLE who intend to become pregnant. • Methotrexate and cyclosporine consumption before and during pregnancy can affect fetal growth. • 7 to 33% of patients whose disease had been suppressed and controlled 6months before pregnancy seams to relapse during the pregnancy. • Taking medications to control the disease during pregnancy plays an important role in the progression of pregnancy and fetus health.

THE PREVALENCE OF ANTIPHOSPHOLIPID SYNDROME IN WOMEN AFTER PREECLAMPSIA

Objective:Preeclampsia (PE) is a multisystem progressive disorder that affects 2–8% of all pregnancies. Severe and early PE (<34 weeks) is one of the clinical criteria of the obstetric antiphospholipid syndrome (APS). The aim of this study was to assess the prevalence of APS in women after PE.Design

Antiphospholipid syndrome in women: Case series and review of literature

Antiphospholipid syndrome in women: Case series and review of literature

Использование бемипарина в лечении акушерского антифосфолипидного синдрома

A study on the treatment of obstetric antiphospholipid syndrome in women with recurrent miscarriage by assigning low molecular weight heparin - bemiparin. The results show that the therapeutic effects of the drug as a preventive and therapeutic doses side effects are not registered. It was possible to achieve a full-term pregnancy to prolong life in 93.5% of cases, premature birth due to placental insufficiency observed in 6.5% of cases. None of the observation is marked by thrombocytopenia, bleeding in the second and third trimesters of pregnancy. At delivery blood loss did not exceed the standard indicators. Anticoagulation bemiparin based therapy was continued for 6 weeks of the postpartum period for the prevention of thrombotic complications.

USE OF ENZYMES IN COMPLEX TREATMENT OF ANTIPHOSPHOLIPID SYNDROME IN WOMEN WITH REPRODUCTIVE LOSSES OF ANDIJAN STATE

Obstetric complications developing at antiphospholipid syndrome are serious medical-social problem. Seeking of the treatment methods sets conditions for urgency of the article reviewed. Enzyme preparations are widely applied for treatment of women with fecundity disorder and hemorheology changes. Research objective was in clinico-laboratorial evaluation of Serrata drug impact in antiphospholipid syndrome in women with reproductive losses of Andijan state. Methods: Data of 43 women in the non-pregnancy state with reproductive losses (RL) in past history with revealed APS had been studied by us. Results: Thus, conducted therapy with Serrata was conductive to haemostasis. Conducted researches confirm the safety of application.

Number and sequence of preceding miscarriages and maternal age for the prediction of antiphospholipid syndrome in women with recurrent miscarriage

To investigate the relationship between the number and sequence of preceding miscarriages and antiphospholipid syndrome (APS). Retrospective cohort study. Recurrent miscarriage (RM) clinic. Women who attended the RM clinic from 1988 to 2006. None. Number, type, and sequence of previous pregnancies were compared between women with APS and women with unexplained RM. A total of 1,719 patients were included; 312 (18%) had APS, and 1,407 (82%) had unexplained RM. The mean maternal age (32.6 years) did not differ between women with and without APS. The median number of miscarriages was three in both groups. A total of 865 women (50%) had a history of at least one live birth, with no difference between the two groups. In both groups, 97% of the women had a history of consecutive miscarriages. The number of preceding miscarriage, type and sequence of previous pregnancies, and maternal age were not associated with APS in women with RM. There is no increased diagnostic yield for APS after three miscarriages rather than after two miscarriages and no increased diagnostic yield for APS after consecutive miscarriages rather than after nonconsecutive miscarriages. Therefore, APS testing should be considered for all women with two or more miscarriages.

Outcomes and treatment of obstetrical antiphospholipid syndrome in women with low antiphospholipid antibody levels

Our objective was to determine whether there is a relationship between low antiphospholipid (aPL) antibody levels and the obstetrical complications of antiphospholipid syndrome (APS) and to analyze the impact of conventional APS treatment in patients with low aPL levels. To this end, we retrospectively reviewed the files of all patients referred to our unit (2003–2010) for unexplained pregnancy morbidity, with an aPL test result. We compared patients with APS confirmed by Sapporo criteria (Group 1) with patients with APS-like obstetrical complications with an aPL titer below the intermediate titer (Group 2). Overall, 57 patients were included (25 in Group 1; 32 in Group 2). Obstetrical events were recurrent spontaneous abortion <10th week of gestation (n=9 patients in Group 1; n=13 patients in Group 2), fetal death (n=11 and 16, respectively), preeclampsia (n=5 in Group 1; n=6 in Group 2). The total number of obstetrical events per patient was very similar before APS treatment (3 [1–8] in Group 1; 3 [1–6] in Group 2) and decreased significantly after APS treatment to 0 [0–2] and 0 [0–2], respectively (p<0.05). The incidence of premature births and the characteristics of neonates were similar in the two groups. In this study, treatment of patients with low aPL levels and APS-like obstetrical events was associated with outcomes similar to those found in otherwise normal women with recurrent miscarriage or other adverse events. However, properly designed treatment trials would be required to prove the benefit of such treatments.

The Euro-Phospholipid project: epidemiology of the antiphospholipid syndrome in Europe

The Euro-Phospholipid project started in 1999 with a multicentre, consecutive and prospective design. A total cohort of 1000 patients with antiphospholipid syndrome (APS), derived from 13 countries (Belgium, Bulgaria, Denmark, France, Germany, Greece, Hungary, Israel, Italy, the Netherlands, Portugal, Spain and United Kingdom), has been followed since then. This project allowed the identification of the prevalence and characteristics of the main clinical and immunological manifestations at the onset and during the evolution of APS and demonstrated that it is possible to recognize more homogeneous subsets of clinical significance. Patients with APS associated with systemic lupus erythematosus (SLE) had more episodes of arthritis, livedo reticularis and more frequently exhibited thrombocytopenia and leucopenia. Female patients had more episodes of arthritis and livedo reticularis - both connected with the higher prevalence of migraine and SLE-related APS in women, while male patients had more myocardial infarction, epilepsy and lower limb arterial thrombosis. Childhood onset patients presented more episodes of chorea and jugular vein thrombosis, whereas older onset patients were more frequently male and had more strokes and angina pectoris, but less frequently livedo reticularis.

A comparison of the uterine and intraovarian arterial flows in women having a history of recurrent spontaneous miscarriage associated with antiphospholipid syndrome

Purpose: To study the relationship between values of Doppler indices characterizing the uterine and intraovarian arterial flows in the presence of antiphospholipid syndrome in women with history of recurrent spontaneous miscarriage (RSM). We are not aware of any previous study undertaken on this specific topic.Methods: Sixty‐two women attending our recurrent spontaneous miscarriage clinic were recruited for this prospective study and subsequently divided to group A (n = 35) involving RSM women with normal anticardiolipin antibodies values (ACL IgM, ACL IgG) and group B (n = 27) for those with antiphospholipid syndrome (abnormal ACL IgM, ACL IgG values). ACL IgM and ACL IgG antibodies were measured in the blood using the standardized enzyme linked immunosorbent assay (ELISA). Color and power Doppler transvaginal ultrasonography was used to estimate the uterine artery pulsatility index (UTAPI), spiral artery resistance index (SARI) and intraovarian resistance index (IOARI) in the 21st day of a regular 28‐day unstimulated menstrual cycle. The data were analyzed using the statistical software SPSS 9.0 Windows. Statistical significance was defined as P &lt; 0.05.Results: There was no statistically significant difference in the mean age in group A (33.67 ± 5.52 years) and group B (32.70 ± 5.85 years), the mean UTAPI values (3.14 ± 1.16 for group A and 3.44 ± 0.88 for group B), the mean SARI values (0.73 ± 0.13 for group A and 0.73 ± 0.07 for group B). The incidence of the first trimester miscarriages in women over 30 years was significantly higher in group B compared with group A (P &lt; 0.01).Conclusions: Our preliminary study has revealed that there was no significant difference in UTAPI, SARI and IOARI values of RSM women with normal and abnormal ACL IgM and ACL IgG values. This fact could be explained by the predominantly mild form of antiphospholipid syndrome in Kuwait confirmed in our previous studies. We could hypothesise that such mild disease will have minimal/mild vascular effects in the non‐pregnant uterus and subsequently in the placental bed.

β2-glycoprotein 1 as a marker of antiphospholipid syndrome in women with recurrent pregnancy loss

Objective: To determine if β2-glycoprotein 1 (β2-GP1) antibodies are a better marker of the antiphospholipid antibody syndrome (APS) in women with recurrent pregnancy loss (RPL). Design: Evaluation and testing of sera from women with RPL. Setting: A university-affiliated reproductive endocrinology practice. Patient(s): 90 women with RPL; 45 women met criteria for APS and 45 women met criteria for RPL without antiphospholipid antibodies (APA). Both groups were of similar age and had a similar history of RPL. Intervention(s): Patient sera were obtained from women with RPL and were tested for APA and β2-GP1. Main Outcome Measure(s): A standard antiphospholipid antibody assay was employed to detect the presence of immunoglobulin (Ig)G, IgM, and IgA antibodies in serum against cardiolipin, phosphatidyl inositol, phosphatidyl glycerol, phosphatidyl serine, and phosphatidyl ethanolamine. Samples were also assayed with a commercial β2-GP1 assay for IgG antibodies. Result(s): Among the 45 women with APS, 10 (22.2%) had positive IgG antibodies for β2-GP1. Only 1 woman (2.2%) of 45 was positive for β2-GP1 among the control group of women with RPL but negative APA. There was no correlation noted among the β2-GP1–positive patients for a specific phospholipid antibody or isotype. Conclusion(s): These data suggest that IgG β2-GP1 antibodies are less sensitive than antiphospholipid antibodies for the diagnosis of APS.

Antiphospholipid antibodies and reproductive outcome: the current state of affairs

Antiphospholipid antibodies were first linked to pregnancy loss more than 20 years ago, and the condition known as antiphospholipid syndrome is perhaps the most convincing ‘immunologic’ disturbance other than anti-erythrocyte and anti-platelet alloimmunization disorders. Specific criteria for the antiphospholipid syndrome have been delineated, the anticardiolipin assay has been standardized, and authorities agree on laboratory criteria defining lupus anticoagulant. Nonetheless, considerable confusion exists regarding antiphospholipid syndrome and related reproductive problems. The state of affairs primarily derives from two problems: the first is the premature introduction of non-standardized antiphospholipid assays into clinical use without rigorous standardization and prior to convincing proof of clinical utility. As a result, well-intending, but less well-versed clinicians sometimes make the diagnosis of antiphospholipid syndrome in women who are negative for lupus anticoagulant and anticardiolipin antibodies. This is especially confusing in the face of growing evidence that the relevant in vivo antiphospholipid antigen is formed by a complex between β2-glycoprotein 1 and phospholipids. A second major problem is that of unwarranted discrepancies in the clinical and laboratory features of patients considered to have a diagnosis of antiphospholipid syndrome. This problem is most apparent in the case selection for pregnancy-loss treatment series and trials. Many series have included women with predominantly pre-embryonic and embryonic pregnancy losses, while others included a large majority of patients with one or more second or third trimester pregnancy losses. Some treatment trials purposefully excluded patients with a history of thrombosis or systemic lupus erythematosus, features found in nearly 50% of patients in other series. Though most authorities require the presence of either lupus anticoagulant or medium-to-high titer IgG anticardiolipin antibodies to make a diagnosis of antiphospholipid syndrome, in some series no more than half of the study patients had lupus anticoagulant and as many as 20% had only IgM anticardiolipin antibodies. It is very unlikely that patients with such disparate clinical and laboratory findings have the same autoimmune syndrome, and a stated or implicit diagnosis of antiphospholipid syndrome in such a wide variety of women is scientifically unsound and clinically dangerous. The relationship between antiphospholipid antibodies and poor reproductive outcomes must be approached through rigorous scientific study and appropriate treatments established by well-designed clinical trials.