Hepatic infarctions during pregnancy are associated with the antiphospholipid syndrome and in addition with complete or incomplete HELLP syndrome (original) (raw)
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Atypical onset of antiphospholipid syndrome in pregnancy
Thrombosis Research, 2005
Background: We present a case of an atypical onset of antiphospholipid syndrome (APS). Case: A woman in her 15th week gestation had a thrombosis of an unknown cerebral cavernoma, which was successfully removed. Twenty-six days after, she was admitted for a severe pain in right hypochondrium and a second class HELLP syndrome was diagnosed. Two days after, she had a fetal loss. After 1 month, laboratory tests revealed high level of antiphospholipid antibodies. At the same time, she developed a spontaneous thrombosis at her right arm. After 6 weeks, antiphospholipid antibodies, tested again, result positive. Conclusion: Antiphospholipid antibodies often cause pregnancy complications, but, to our knowledge, this is the first report of an association of antiphospholipid antibodies, with cerebral cavernoma thrombosis and early onset HELLP syndrome. D
Collegium antropologicum, 2007
The aim of the research was to show our diagnostic and therapeutic experience with antiphospholipid syndrome (APS) in pregnant women. 36 pregnant women suspect on APS were included in the study: 32 with primary antiphospholipd syndrome (PAPS) and 4 with secondary antiphospholipid syndrome (SAPS). All pregnant women received low-molecular-weight-heparin (LMWH) and low dose aspirin (LDA) therapy. Control group represented 26 women with SAPS and previous bad reproductive anamnesis. Average pregnancy lasted 37.06 +/- 0.707 weeks. LMWH and LDA therapy was successful in 97.22%. Lupus anticoagulant (LA) was found to be more frequent in PAPS group (71.87%). Anticardiolipin antibodies (aCL) were found to be more frequent in SAPS (26.66%). For three patients (3.37%), PAPS was diagnosed due to a fact that they had positive antibeta2-glycoproteinl (antibeta-GP1). To make APS diagnosis, it is of great importance to search for all antiphospholipid antibodies. LMWH and low dose of acetylsalicylic ...
Antiphospholipid Syndrome during pregnancy: the state of the art
Journal of prenatal medicine, 2011
Obstetric complications are the hallmark of antiphospholipid syndrome. Recurrent miscarriage, early delivery, oligohydramnios, prematurity, intrauterine growth restriction, fetal distress, fetal or neonatal thrombosis, pre-eclampsia/eclampsia, HELLP syndrome, arterial or venous thrombosis and placental insufficiency are the most severe APS-related complication for pregnant women. Antiphospholipid antibodies promote activation of endothelial cells, monocytes and platelets, causing an overproduction of tissue factor and thromboxane A2. Complement activation might have a central pathogenetic role. These factors, associated with the typical changes in the hemostatic system during normal pregnancy, result in a hypercoagulable state. This is responsible of thrombosis that is presumed to provoke many of the pregnancy complications associated with APS. Obstetric care is based on combined medical-obstetric high-risk management and treatment with the association between aspirin and heparin. T...
Consequences of antiphospholipid syndrome in pregnancy - A review
Revista română de reumatologie, 2023
Background and objectives. Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by the presence of antiphospholipid antibodies (aPL) in the blood. Antiphospholipid syndrome is defined by the presence of antiphospholipid antibodies, including lupus anticoagulant, anticardiolipin antibodies, and anti-beta-2 glycoprotein I antibodies. These antibodies target phospholipids-binding proteins and can leading to various clinical manifestations and complications of thromboembolic nature. Also, the antiphospholipid syndrome is strongly linked to adverse pregnancy outcomes, including recurrent miscarriages, fetal growth restriction, preeclampsia, and preterm birth. Placental dysfunction, impaired blood flow to the fetus, and thrombotic events within the placenta contribute to these complications. The purpose of this review was the research of consequences of antiphospholipid syndrome in pregnancy. Materials and methods. This research involves systematically reviewing and analyzing existing literature on consequences of antiphospholipid syndrome in pregnancy. For relevant literature, academic databases like Pub Med, Scopus, Web of Science, and Google Scholar were used. Search terms and keywords that were used to search for relevant literature in databases was: antiphospholipid syndrome; pregnancy; consequences, and Boolean operator (AND, OR). The criteria used to include literature in this review were; publication date, language, study objectives, study design, research methodology, key findings, and relevance to my research question. For citation and referencing were used the appropriate citation style (e.g., APA, MLA, Chicago, Harvard and Vancouver). Results. The main findings in this review were that antiphospholipid syndrome (APS) of characterizing by dysregulation of the immune system and the production of autoantibodies.These autoantibodies can target various cells and proteins, leading to inflammation, tissue damage, and disrupted physiological processes. This syndrome is associated with a prothrombotic state, increasing the risk of blood clots in veins and arteries. Antiphospholipid syndrome (APS) can affect multiple organs and systems, including the skin, kidneys, heart, and central nervous system. Thrombotic events can occur in various organs, leading to deep vein thrombosis, pulmonary embolism, strokes, and other thromboembolic complications. Also, the antiphospholipid syndrome is strongly linked to adverse pregnancy outcomes, including recurrent miscarriages, fetal growth restriction, preeclampsia, and preterm birth. Placental dysfunction, impaired blood flow to the fetus, and thrombotic events within the placenta contribute to these complications. Manifestations may include skin rashes (livedo reticularis), kidney involvement (glomerulonephritis), heart valve abnormalities, and neurological symptoms etc. Conclusions. We come to the conclusion that it is essential for the pregnant women with antiphospholipid syndrome to receive close monitoring and appropriate management to reduce the risk and severity of these pregnancy complications. This may include interventions such as anticoagulation therapy, regular prenatal care, monitoring of fetal growth and wellbeing, and prompt management of complications. A multidisciplinary approach involving obstetricians, rheumatologists, and other healthcare professionals is often necessary to optimize outcomes for both the mother and the baby.
Primary antiphospholipid syndrome: pregnancy outcome in a portuguese population
Acta Reumatológica Portuguesa, 2009
Women with antiphospholipid syndrome (APS) may suffer from recurrent miscarriage, fetal death, fetal growth restriction (FGR), pre-eclampsia, placental abruption, premature delivery and thrombosis. Treatment with aspirin and low molecular weight heparin (LMWH) combined with close maternal-fetal surveillance can change these outcomes. To assess maternal and perinatal outcome in a cohort of Portuguese women with primary APS. A retrospective analysis of 51 women with primary APS followed in our institution (January 1994 to December 2007). Forty one (80.4%) had past pregnancy morbidity and 35.3% (n=18) suffered previous thrombotic events. In their past they had a total of 116 pregnancies of which only 13.79 % resulted in live births. Forty four patients had positive anticardiolipin antibodies and 33 lupus anticoagulant. All women received treatment with low dose aspirin and LMWH. There were a total of 67 gestations (66 single and one multiple). The live birth rate was 85.1% (57/67) with...
Anti-Prothrombin Antibodies are Associated with Adverse Pregnancy Outcome
American Journal of Reproductive Immunology, 2011
Adverse pregnancy outcomes such as severe earlyonset pre-eclampsia, placental insufficiency, and ⁄ or abruption, as well as late fetal loss, have been associated with antiphospholipid antibodies (aPL), namely anticardiolipin antibodies (aCL), anti-b 2 glycoprotein-1 antibodies (anti-b 2 GPI), and lupus anticoagulant (LAC), and they are criteria for the diagnosis of the 'antiphospholipid syndrome'. 1 The association is explained by a potential direct effect of the antibodies on the trophoblasts and by an indirect thrombogenic effect on placental vessels, eventually leading to 'vascular' complications in late pregnancy (i.e., pre-eclampsia, fetal death, or placental abruption). However, in most cases of such adverse pregnancy outcomes, aPL are absent. It has been observed that aPL consist of a heterogeneous group of antibodies targeting phospholipidbinding plasma proteins involved in coagulation
Arthritis Research & Therapy, 2021
Background The criteria for antiphospholipid syndrome (APS) include severe preeclampsia and/or placental insufficiency leading to preterm delivery before 34 weeks of gestation, but this APS manifestation has been rarely studied. Thus, we report a series of severe preeclampsia occurred in patients with APS. Methods We retrospectively analysed data of women with APS (Sydney criteria) who experienced severe preeclampsia with delivery before 34 weeks’ gestation between 2000 and 2017 at five French internal medicine departments and one Italian rheumatology unit. Results The 40 women had a mean age of 30.5 ± 4.6 years at their first episode of preeclampsia; 21 were nulligravid (52.5%), 12 (30%) had already been diagnosed with APS, and 21 (52.5%) had a triple-positive antiphospholipid (aPL) antibody test. Preeclampsia occurred at a median gestational age of 25.5 weeks (IQR 23-29). It was associated with HELLP in 18 cases (45%), eclampsia in 6 (15%), placental abruption in 3 (7.5%), catastr...