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Mayer-Pickel, K; Eberhard, K; Lang, U; Cervar-Zivkovic, M.
Pregnancy Outcome in Women with Obstetric and Thrombotic Antiphospholipid Syndrome-A Retrospective Analysis and a Review of Additional Treatment in Pregnancy.
Clin Rev Allergy Immunol. 2017; 53(1):54-67 Doi: 10.1007/s12016-016-8569-0 [OPEN ACCESS]
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Führende Autor*innen der Med Uni Graz
Mayer-Pickel Karoline Ilse
Co-Autor*innen der Med Uni Graz
Cervar-Zivkovic Mila
Eberhard Katharina
Lang Uwe
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Abstract:
Antiphospholipid syndrome (APS) is associated with pregnancy complications such as recurrent early fetal loss (RFL), fetal death, preeclampsia (PE), and intrauterine growth restriction (obstetric APS/OAPS). Other clinical manifestations are venous and/or arterial thromboses (thrombotic APS/TAPS). The data of 37 pregnancies with OAPS and 37 pregnancies with TAPS were analyzed and compared. Overall, the most frequent APS antibodies (aPl) were LA as well as "triple-positivity"; LA antibodies were significantly more frequent in women with TAPS (67.6 % TAPS vs. 29.7 % OAPS, p < 0.010), whereas "triple-positivity" was significantly more seen in women with OAPS (40.5 % OAPS vs. 13.5 % TAPS, p < 0.010). Adequate therapy has been administered in nearly all pregnancies with TAPS, whereas in 18.9 % of pregnancies with OPS, no therapy has been given at all. One woman in OAPS and four women in TAPS were treated with plasmapheresis and immunoadsorption. There was no significant association between adverse obstetric outcome and therapy. The most frequent pregnancy complications were RFL in the OAPS group (32.4 vs. 13.5 % in TAPS) and PE in the TAPS group (18.9 % in OAPS and TAPS, respectively). The data of our study showed that pregnancies with OAPS and TAPS have a similar rate of pregnancy complications. However, pregnancies with OAPS tend to have rather RFL. Although we were not able to reveal a significant association with adverse obstetric outcome, it seems that the current adequate therapy for APS in pregnancy, consisting of LDA and LMWH, might rather prevent the development of RFL. Additionally, it might be considered to divide the obstetric APS into obstetric APS with early pregnancy complications and obstetric APS with late pregnancy complications. The division into two groups of obstetric APS might facilitate the choice of additional therapy in these women.
Find related publications in this database (using NLM MeSH Indexing)
Antibodies, Antiphospholipid - blood
Antibodies, Antiphospholipid - immunology
Antiphospholipid Syndrome - blood
Antiphospholipid Syndrome - immunology
Antiphospholipid Syndrome - therapy
Autoantibodies - blood
Autoantibodies - immunology
Female -
Humans -
Plasmapheresis -
Pre-Eclampsia - blood
Pre-Eclampsia - immunology
Pregnancy -
Pregnancy Complications - blood
Pregnancy Complications - immunology
Pregnancy Complications - therapy
Pregnancy Outcome -
Retrospective Studies -
Thrombosis -

Find related publications in this database (Keywords)
Antiphospholipid syndrome
Pregnancy
Preeclampsia
Thrombosis
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