Syndrome des anticorps antiphospholipides et grossesse : pronostic obstétrical selon le type de SAPL

Delesalle, C.; Vienne, C. De; Hello, C. Le; Verspyck, É.; Dreyfus, Michel

doi:10.1016/j.jgyn.2014.06.002

Cited by 2 publications

(1 citation statement)

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“…The 11 women (17%) with no live births were mostly still of reproductive age by the end of the follow-up period (median age 34 years (IQR 31–37)). The prognosis for a pregnancy thus appears to be encouraging when appropriate treatment is implemented [ 24 ]. In light of these data and our results, we consider that women with APS who experience an IUFD should receive both LDA and LMWH for subsequent pregnancies, as well as appropriate education.…”

Section: Discussionmentioning

confidence: 99%

Intrauterine fetal deaths related to antiphospholipid syndrome: a descriptive study of 65 women

Belhocine¹,

Coutte²,

Silva

et al. 2018

Arthritis Res Ther

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ObjectiveAlthough one of the three obstetric manifestations of antiphospholipid syndrome (APS) is intrauterine fetal death (IUFD), little is known about it in this context. We report the first large series of patients with APS and IUFD.MethodsWe retrospectively analyzed the history and clinical data of women at four French hospitals. All had (1) APS diagnosis (Sydney criteria) and (2) IUFD at or after 10 weeks of gestation (weeks) between 2000 and 2016.ResultsThe study included 65 women. Their median age at the index IUFD was 29 years (IQR 26–33); 38 (58%) were primigravidas. The index IUFD was the first APS clinical manifestation in 48 women (74%). Overall, 35% had a triple-positive antibody profile.IUFD occurred at a median gestational age of 24 weeks (IQR 18–27) and was associated with maternal obstetric complications in 16 women (25%), namely, preeclampsia (n = 12), hemolysis, elevated liver enzymes, and low platelet syndrome (HELLP) (n = 6), and/or placental abruption (n = 5). Half of the 50 women with available data had a small-for-gestational-age fetus.Overall, including during the follow-up period of 4 years (IQR 2–9), 28 women (43%) had at least one thrombosis, and 29% were diagnosed with systemic lupus erythematosus (SLE). Ultimately, 54 women (83%) had at least one live birth. Only one woman had three consecutive early miscarriages.ConclusionIUFD was most often the inaugural sign of APS. Of the APS classification criteria, IUFD, preeclampsia, and thromboses were common in this cohort, while the “3 consecutive early miscarriages” criterion was met only once. With treatment, most of the women successfully had at least one live birth.

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Section: Discussionmentioning

confidence: 99%