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Obstetric Anti-phospholipid Syndrome: State of the Art

  • Antiphospholipid Syndrome (S Zuily, Section Editor)
  • Published:
Current Rheumatology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

This review focuses on new pathogenesis and clinical-therapeutic aspects of obstetric anti-phospholipid syndrome (ob-APS) in the last 5 years.

Recent Findings

The pathogenesis of ob-APS is multifactorial, including placental infarctions, infiltration of inflammatory cells that cause acute and chronic inflammation, leading to uncontrolled inflammation and poor pregnancy outcomes. A preconception counseling and a patient-tailored treatment are fundamental to improve maternal and fetal outcomes. Thanks to conventional treatment, based on low-dose aspirin and heparin, 70% of women with ob-APS can have successful pregnancies. Women with positive anti-phospholipid antibodies (aPL) without clinical manifestations (“aPL carriers”) or with obstetric manifestation not fulfilling ob-APS criteria need to be further investigated in order to assess their best management.

Summary

Great interest has been given to drugs that could interact in the pathophysiological mechanisms, such as hydroxychloroquine, statins, and eculizumab. These drugs could be considered for patients refractory to conventional therapy.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Rheumatology and Clinical Immunology Unit and Department of Clinical and Experimental Sciences, Spedali Civili and University of Brescia, Brescia, Italy

    Maria Chiara Gerardi, Angela Tincani & Laura Andreoli

  2. Autoimmune Disease Unit—Department of Internal Medicine, Hospital Curry Cabral/Centro Hospitalar Lisboa Central, Lisbon, Portugal

    Melissa Alexandre Fernandes

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  1. Maria Chiara Gerardi
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  2. Melissa Alexandre Fernandes
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  3. Angela Tincani
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  4. Laura Andreoli
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Correspondence to Laura Andreoli.

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This article is part of the Topical Collection on Antiphospholipid Syndrome

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Gerardi, M.C., Fernandes, M.A., Tincani, A. et al. Obstetric Anti-phospholipid Syndrome: State of the Art. Curr Rheumatol Rep 20, 59 (2018). https://doi.org/10.1007/s11926-018-0772-y

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