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Management of Obstetric Antiphospholipid Syndrome

  • ANTIPHOSPHOLIPID SYNDROME (RAS ROUBEY, SECTION EDITOR)
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Abstract

Recurrent early miscarriages (excluding chromosomal anomalies), late fetal loss, and maternal thrombosis are characteristic of obstetric antiphospholipid syndrome (APS). Obstetric complications such as preeclampsia, fetal growth restriction, premature delivery, and fetal death also occur in higher frequency in APS patients than in the general population. A high-risk obstetric center is needed for proper evaluation of and intervention with pregnant women with APS. Association with lupus carries additional risk of thrombosis when antiphospholipid antibodies (aPLs) are present. Gestational results with live births are improved to about 80% when antithrombotic therapy is used, but failure in 20% to 30% of the cases despite correct treatment with low-dose aspirin with or without heparin reveals new pathways for pregnancy loss in APS and unmet needs. At the moment, there is no recommendation to investigate patients with infertility for the presence of aPLs.

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Disclosure

Dr. G.R.R. de Jesus has had travel/accommodations expenses covered/reimbursed by Biorad Laboratories.

Dr. N.R. de Jesus has had travel/accommodations expenses covered/reimbursed by Biorad Laboratories.

Dr. Levy has received grant support from FAPERJ and the Federico Foundation.

Drs. dos Santos, Oliveira, and Mendes-Silva reported no potential conflicts of interest relevant to this article.

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Authors and Affiliations

  1. Department of Obstetrics, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, 131 Jorge Rudge Street, Apartment 506 bl 1, Vila Isabel, Rio de Janeiro, RJ, Brazil, 20550-220

    Guilherme Ribeiro Ramires de Jesus & Nilson Ramires de Jesus

  2. Department of Obstetrics, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Silveira Martins street, 103, Catete, Rio de Janeiro, RJ, Brazil

    Flavia Cunha dos Santos

  3. Department of Rheumatology, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, 71 Baronesa de Poconé street, 1001, Lagoa, Rio de Janeiro, RJ, Brazil

    Camila Souto Oliveira

  4. Department of Obstetrics, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, 36 Boulevard 28 de Setembro, 803, Vila Isabel, Rio de Janeiro, RJ, Brazil

    Wallace Mendes-Silva

  5. Department of Rheumatology, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, 38 Anita Garibaldi street, 101, Copacabana, Rio de Janeiro, RJ, Brazil

    Roger Abramino Levy

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  1. Guilherme Ribeiro Ramires de Jesus
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  2. Flavia Cunha dos Santos
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  3. Camila Souto Oliveira
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  4. Wallace Mendes-Silva
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  5. Nilson Ramires de Jesus
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  6. Roger Abramino Levy
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Correspondence to Guilherme Ribeiro Ramires de Jesus.

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de Jesus, G.R.R., dos Santos, F.C., Oliveira, C.S. et al. Management of Obstetric Antiphospholipid Syndrome. Curr Rheumatol Rep 14, 79–86 (2012). https://doi.org/10.1007/s11926-011-0218-2

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