Semin Thromb Hemost 2008; 34(3): 267-273
DOI: 10.1055/s-0028-1082270
© Thieme Medical Publishers

Lupus and the Antiphospholipid Syndrome in Pregnancy and Obstetrics: Clinical Characteristics, Diagnosis, Pathogenesis, and Treatment

Angela Tincani1 , 3 , Chiara Bazzani1 , 3 , Stefania Zingarelli1 , 3 , Andrea Lojacono2 , 3
  • 1Rheumatology and Clinical Immunology, Brescia, Italy
  • 2Obstetric and Gynecology, Brescia, Italy
  • 3Spedali Civili and University of Brescia, Brescia, Italy
Further Information

Publication History

Publication Date:
21 August 2008 (online)

ABSTRACT

The antiphospholipid syndrome (APS) in pregnancy is associated with repeated miscarriages and fetal loss. Other complications of pregnancy such as preeclampsia and placental insufficiency are also frequently reported during pregnancy in APS. The pathogenesis of pregnancy failures in APS is related to both the thrombophilic effect of antiphospholipid antibodies and also to different mechanisms including a direct effect of antibodies on trophoblast differentiation and invasion. Although optimal pharmacologic treatment is essential to achieve a successful outcome in APS pregnancy, the standard APS pharmacologic treatment alone may not be sufficient. A good obstetric outcome is the result of careful obstetric monitoring, proper delivery timing, and skillful neonatal care. A multidisciplinary team (obstetricians, rheumatologists, and neonatologists) and the progress in neonatal intensive care are as important as drugs in achieving a good obstetric outcome and to reduce the possible consequences of premature delivery.

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Angela TincaniM.D. 

Reumatologia e Immunologia Clinica, Spedali Civili e Università di Brescia

Piazza Spedali Civili 1, 25123 Brescia, Italy

Email: tincani@bresciareumatologia.it

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