Prevalence and significance of antiphospholipid antibodies in selected at-risk obstetrics cases: A comparative prospective study

Saha, Sarama; Bhattacharjee, Nabendu; Ganguli, Rohan; S, Sil; Patra, Kajal Kumar; Sengupta, Mini; Barui, Gangotri; Goswami, B. K.

doi:10.1080/01443610903052073

Cited by 13 publications

(11 citation statements)

References 24 publications

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“…In this study IgG and IgM antibodies were seen in 1 (1.3 %) and 3 (3.8 %) patients respectively. The prevalence is lower than that observed by other authors [15,16]. The prevalance of LA was thrice that of ACA and this observation was in contrast to other studies [6,30].…”

Section: Discussioncontrasting

confidence: 56%

“…In a study on 30 Indian women with unexplained fetal loss, LA was observed in 16.6 % patients [17]. Saha et al [15] reported LA in 13.4 % patients with obstetric complications. Vora et al [16] observed LA positivity in 8.1 % of 430 women with fetal loss.…”

Section: Discussionmentioning

confidence: 99%

“…The reported frequency of antiphospholipid antibodies in women with fetal loss is variable with values ranging from 3 to 48 % for LA and 8-50 % for ACA [12][13][14][15][16][17]. This wide variation is due to different laboratory tests used for diagnosis.…”

Section: Discussionmentioning

confidence: 99%

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Lupus Anticoagulants and Anticardiolipin Antibodies in Indian Women with Spontaneous, Recurrent Fetal Loss

Rawat

Sikka

Rusia

et al. 2014

Indian J Hematol Blood Transfus

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Spontaneous and recurrent pregnancy loss are common complications of pregnancy resulting from varied causes including antiphospholipid syndrome (APS). Treatment of women with APS increases the chance of a subsequent successful pregnancy. The study aimed to find the prevalence of lupus anticoagulants (LA) and anticardiolipin antibodies (ACAs) in women with spontaneous/ recurrent fetal loss and compare with women with normal obstetric history. Hundred women with spontaneous/ recurrent fetal loss and 50 healthy pregnant controls were tested for LA by complete blood counts, Prothrombin time, Activated partial thromboplastin time (APTT), LA sensitive APTT and dilute Russell viper venom time (dRVVT) (screening and confirmatory) and ACAs (ELISA). LA was detected in 15 % patients using dRVVT confirmatory test and ACA in 5 %, all controls being negative. Twenty one % patients were detected by LA sensitive APTT (sensitivity 92.9 %, specificity 100 %) and 100 % with dRVVT screening test (sensitivity 98.8 %, specificity 100 %). We recommend that screening for antiphospholipid antibodies must be done in women with spontaneous/recurrent foetal loss even in the absence of other clinical manifestations using a combination of tests.

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

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Lupus Anticoagulants and Anticardiolipin Antibodies in Indian Women with Spontaneous, Recurrent Fetal Loss

Rawat

Sikka

Rusia

et al. 2014

Indian J Hematol Blood Transfus

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“…Conceivably, an increased risk for hypertension in these patients may lead to a higher risk for pre-eclampsia, a wellrecognized pregnancy complication among patients with antiphospholipid syndrome (46). The main weakness of our paper is that of all meta-analyses: it is limited by the quality of the studies included.…”

Section: Discussionmentioning

confidence: 89%

A Systematic Review and Meta-Analysis of Pregnancy Outcomes in Patients with Systemic Lupus Erythematosus and Lupus Nephritis

Smyth¹,

Oliveira²,

Lahr

et al. 2010

Clinical Journal of the American Society of Nephrology

546

437

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Background and objectives: Studies of the impact of systemic lupus erythematosus (SLE) and its pregnancy complications have yielded conflicting results. Major limitations of these studies relate to their small numbers of patients and retrospective designs. The aim of this study was to perform a systematic literature review of pregnancy outcomes in women with SLE and a meta-analysis of the association of lupus nephritis with adverse pregnancy outcomes.Design, setting, participants, & measurements: We searched electronic databases from 1980 to 2009 and reviewed papers with validity criteria. Random-effects analytical methods were used to evaluate pregnancy complications rates.Results: Thirty-seven studies with 1842 patients and 2751 pregnancies were included. Maternal complications included lupus flare (25.6%), hypertension (16.3%), nephritis (16.1%), pre-eclampsia (7.6%), and eclampsia (0.8%). The induced abortion rate was 5.9%, and when excluded, fetal complications included spontaneous abortion (16.0%), stillbirth (3.6%), neonatal deaths (2.5%), and intrauterine growth retardation (12.7%). The unsuccessful pregnancy rate was 23.4%, and the premature birth rate was 39.4%. Meta-regression analysis showed statistically significant positive associations between premature birth rate and active nephritis and increased hypertension rates in subjects with active nephritis or a history of nephritis. History of nephritis was also associated with pre-eclampsia. Anti-phospholipid antibodies were associated with hypertension, premature birth, and an increased rate of induced abortion.Conclusions: In patients with SLE, both lupus nephritis and anti-phospholipid antibodies increase the risks for maternal hypertension and premature births. The presented evidence further supports timing of pregnancy relative to SLE activity and multispecialty care of these patients.

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“…Antiphospholipid antibodies have been reported as prevalent (10% to 30%) among women with preeclampsia. 27,28 Excluding aPTT from our de nition of the outcome "abnormal coagulation" was felt to be appropriate because clinicians clearly did not feel it was an important investigation.…”

Section: Discussionmentioning

confidence: 99%

The Role of Platelet Counts in the Assessment of Inpatient Women With Preeclampsia

Laskin

Payne

Hutcheon

et al. 2011

Journal of Obstetrics and Gynaecology Canada

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Objective: Platelet count has been proposed as a screening test for generalized coagulopathy in women with preeclampsia We performed this study to determine the relationship between platelet counts and the risk of abnormal coagulation and adverse maternal outcomes in women with preeclampsia Methods:We used data from women in the PIERS (Pre-eclampsia Integrated Estimate of RiSk) database Abnormal coagulation was de ned as either an international normalized ratio result greater than and/or a serum brinogen level less than the BC Women's Hospital laboratory's pregnancy-speci c normal range The relationship between platelet counts and adverse maternal outcomes was explored using a logistic regression analysis The sensitivity, speci city, positive predictive value, and negative predictive value of platelet counts in identifying abnormal coagulation or adverse maternal outcomes were calculatedReslts: Abnormal coagulation occurred in 105 of 1405 eligible women (75%) The odds of having abnormal coagulation were increased for women with platelet counts < 50 × 10 9 /L (OR 778; 95% CI 336 to 1803) and between 50 and 99 × 10 9 /L (OR 269; 95% CI 144 to 501) compared with women who had platelet counts above 150 × 10 9 /L Platelet counts < 100 × 10 9 /L were associated with signi cantly increased odds of adverse maternal outcomes, most speci cally blood transfusion A platelet count of < 100 × 10 9 /L had good speci city in identifying abnormal coagulation and adverse maternal outcomes (92% [95% CI 91% to 94%] and 92% [95% CI 91% to 94%], respectively), but poor sensitivity (22% [95% CI 15% to 31%] and 16% [95% CI 11% to 23%], respectively) Conclsion: A platelet count < 100 × 10 9 /L is associated with an increased risk of abnormal coagulation and maternal adverse outcomes in women with preeclampsia However, the platelet count should not be used in isolation to guide care because of its poor sensitivity Whether or not a platelet count is normal should not be used to determine whether further coagulation tests are needed Résltats : Une coagulation anormale s'est manifestée chez 105 des 1 405 femmes admissibles (7,5 %) Les risques de présenter une coagulation anormale étaient accrus chez les femmes qui comptaient des numérations plaquettaires < 50 × 10 9 /l (RC,7,78; IC à 95 %,3,03) The Role of Platelet Conts in the Assessment of Inpatient Women With Preeclampsia avec les femmes qui comptaient des numérations plaquettaires se situant au-delà de 150 × 10 9 /l Les numérations plaquettaires < 100 × 10 9 /l ont été associées à une hausse signi cative des risques de connaître des issues maternelles indésirables, plus particulièrement une transfusion sanguine Une numération plaquettaire < 100 × 10 9 /l présentait une bonne spéci cité pour ce qui est de l'identi cation d

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Prevalence and significance of antiphospholipid antibodies in selected at-risk obstetrics cases: A comparative prospective study

Cited by 13 publications

References 24 publications

Lupus Anticoagulants and Anticardiolipin Antibodies in Indian Women with Spontaneous, Recurrent Fetal Loss

Lupus Anticoagulants and Anticardiolipin Antibodies in Indian Women with Spontaneous, Recurrent Fetal Loss

A Systematic Review and Meta-Analysis of Pregnancy Outcomes in Patients with Systemic Lupus Erythematosus and Lupus Nephritis

The Role of Platelet Counts in the Assessment of Inpatient Women With Preeclampsia

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