Antiphospholipid Syndrome in Pregnancy

The antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by arterial and venous thrombosis, gestational morbidity and presence of elevated and persistently positive serum titers of antiphospholipid antibodies. Antiphospholipid syndrome may exist as an isolated immunologic derangement primary APS (PAPS) or as secondary antiphospholipid syndrome (SAPS) where it occurs in association with autoimmune disease, most commonly SLE. The diagnosis of APS should be suggested whenever patient has history of repeated pregnancy loss without any fetal malformation or foetal death in utero. Other pregnancy complications mainly include intrauterine growth restriction (IUGR), oligohydramnios, preeclampsia, fetal distress, and preterm labor. A severe complication of pregnancy, which greatly increases its risk in case of APS, is VTE. Pregnant and postpartum women are approximately 4 to 5 times more likely to develop VTE compared with non pregnant women. Many other clinical manifestations may occur. Pregnant women with APS are considered high-risk obstetric patients, and medical care should be instituted keeping this in mind.