Antiphospholipid syndrome Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(1):40-46
DOI 10.1590/S0100-72032012000100008
PURPOSE: To determine the frequency and the association of serum markers for inherited and acquired thrombophilias in pregnant women with a history of severe pre-eclampsia in previous pregnancies. METHODS: Case-control study consisting of 81 pregnant women with a history of severe pre-eclampsia in previous pregnancies (study group) and 32 women with no history of severe pre-eclampsia in previous pregnancies (control group). The presence of inherited thrombophilia and antiphospholipid antibodies was screened in both groups. We used the chi-square test with Yates correction to assess associations and calculate the relative risks. RESULTS: The presence of thrombophilia was detected in 60.0% of patients with a previous history of pre-eclampsia and in 6.0% of the control patients. A significant association was found between pre-eclampsia in a previous pregnancy and the presence of markers for hereditary thrombophilia/antiphospholipid antibodies (p<0.05). The relative risk to develop pre-eclampsia was found to be 1.57 (1.34
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(1):40-46
DOI 10.1590/S0100-72032012000100008
PURPOSE: To determine the frequency and the association of serum markers for inherited and acquired thrombophilias in pregnant women with a history of severe pre-eclampsia in previous pregnancies. METHODS: Case-control study consisting of 81 pregnant women with a history of severe pre-eclampsia in previous pregnancies (study group) and 32 women with no history of severe pre-eclampsia in previous pregnancies (control group). The presence of inherited thrombophilia and antiphospholipid antibodies was screened in both groups. We used the chi-square test with Yates correction to assess associations and calculate the relative risks. RESULTS: The presence of thrombophilia was detected in 60.0% of patients with a previous history of pre-eclampsia and in 6.0% of the control patients. A significant association was found between pre-eclampsia in a previous pregnancy and the presence of markers for hereditary thrombophilia/antiphospholipid antibodies (p<0.05). The relative risk to develop pre-eclampsia was found to be 1.57 (1.34
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(5):235-240
DOI 10.1590/S0100-72032007000500003
PURPOSE: to establish the prevalence of thrombophilic factors in infertile women. METHODS: a cross-sectional study was performed, in which infertile women, seen in a private clinic with investigation for thrombophilia were included, according to the protocol of the clinic, between March 2003 and March 2005, after the approval of the Research Ethics Committee of the Universidade Estadual de Campinas (UNICAMP). One hundred and forty-four infertile women without any liver disease were evaluated. Infertility is defined as one year of unprotected sexual intercourse without conception. The acquired and/or inherited thrombophilic factors investigated were: anticardiolipin antibody (aCL), lupus anticoagulant (LA), protein C deficiency (PCD), protein S deficiency (PSD), antithrombin III deficiency (ATD), presence of the factor V Leiden, mutation G20 210A in the prothrombin gene, and C677T mutation of methylene tetrahydrofolate reductase (MTHFR). RESULTS: the prevalence values obtained for aCL and LA were 2%. The prevalence of the hereditary thrombophilic factors were: PCD=4%, PSD=6%, ATD=5%, factor V Leiden=3%, prothrombin mutation=3%, MTHFR mutation=57%. Conclusions: of the 144 patients selected, 105 women (72.9%) presented at least one thrombophilic factor. This reinforces the importance and justifies the need of investigation in this group.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(5):235-240
DOI 10.1590/S0100-72032007000500003
PURPOSE: to establish the prevalence of thrombophilic factors in infertile women. METHODS: a cross-sectional study was performed, in which infertile women, seen in a private clinic with investigation for thrombophilia were included, according to the protocol of the clinic, between March 2003 and March 2005, after the approval of the Research Ethics Committee of the Universidade Estadual de Campinas (UNICAMP). One hundred and forty-four infertile women without any liver disease were evaluated. Infertility is defined as one year of unprotected sexual intercourse without conception. The acquired and/or inherited thrombophilic factors investigated were: anticardiolipin antibody (aCL), lupus anticoagulant (LA), protein C deficiency (PCD), protein S deficiency (PSD), antithrombin III deficiency (ATD), presence of the factor V Leiden, mutation G20 210A in the prothrombin gene, and C677T mutation of methylene tetrahydrofolate reductase (MTHFR). RESULTS: the prevalence values obtained for aCL and LA were 2%. The prevalence of the hereditary thrombophilic factors were: PCD=4%, PSD=6%, ATD=5%, factor V Leiden=3%, prothrombin mutation=3%, MTHFR mutation=57%. Conclusions: of the 144 patients selected, 105 women (72.9%) presented at least one thrombophilic factor. This reinforces the importance and justifies the need of investigation in this group.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(4):215-221
DOI 10.1590/S0100-72031999000400006
Purpose: to determine the effectiveness and the safety of treatment with heparin and low-dose aspirin in pregnant women with antiphospholipid syndrome, and to determine possible deteriorating factors for this syndrome. Methods: 17 patients with antiphospholipid syndrome were submitted to a rigorous antenatal care. Patients were treated with a fixed dose of heparin (10,000 IU/day) associated with low-dose aspirin (100 mg/day). We analyzed perinatal and maternal results, using chi² test and Fischer's exact test. Results: the overall live birth rate was 88.2% in treated pregnancies of these patients versus 13.3% of their previous nontreated pregnancies. The incidence of adverse pregnancy outcomes was very significant: oligohydramnios (40%), fetal distress (33.3%), fetal growth retardation (33.3%), gestational diabetes (29.4%), preeclampsia(23.5%), and preterm delivery (60%). The presence of systemic lupus erythematosus was an indication of poor prognosis. No significant side effects were observed during the treatment. Conclusions: this treatment was effective to improve live birth rate, safe, but it was not able to avoid adverse pregnancy outcomes associated with antiphospholipid syndrome. Systemic lupus erythematosus was a deteriorating factor for this syndrome.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(4):215-221
DOI 10.1590/S0100-72031999000400006
Purpose: to determine the effectiveness and the safety of treatment with heparin and low-dose aspirin in pregnant women with antiphospholipid syndrome, and to determine possible deteriorating factors for this syndrome. Methods: 17 patients with antiphospholipid syndrome were submitted to a rigorous antenatal care. Patients were treated with a fixed dose of heparin (10,000 IU/day) associated with low-dose aspirin (100 mg/day). We analyzed perinatal and maternal results, using chi² test and Fischer's exact test. Results: the overall live birth rate was 88.2% in treated pregnancies of these patients versus 13.3% of their previous nontreated pregnancies. The incidence of adverse pregnancy outcomes was very significant: oligohydramnios (40%), fetal distress (33.3%), fetal growth retardation (33.3%), gestational diabetes (29.4%), preeclampsia(23.5%), and preterm delivery (60%). The presence of systemic lupus erythematosus was an indication of poor prognosis. No significant side effects were observed during the treatment. Conclusions: this treatment was effective to improve live birth rate, safe, but it was not able to avoid adverse pregnancy outcomes associated with antiphospholipid syndrome. Systemic lupus erythematosus was a deteriorating factor for this syndrome.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(3):179-183
DOI 10.1590/S0100-72032006000300007
PURPOSE: to diagnose and treat diabetic pregnant women with antiphospholipid antibodies and to describe the gestational and perinatal results. METHODS: we evaluated 56 gestational and pregestational diabetic women who were attended at one specialized prenatal care unit, between July 2003 and March 2004. All of them had a blood test to quantify antiphospholipid antibodies. If positive, they were treated with heparin and aspirin at low doses and the usual treatment for diabetes. We calculated the prevalence and 95% confidence interval for all and also those for the pregestational ones. The characteristics of the pregnancies and the newborns are described. RESULTS: antiphospholipid antibodies prevalence among the diabetic pregnant women was 7% (95% CI - 0.1 to 13.9). Among pregestational diabetic women it was 12% (95% CI - 0.2 to 23.3). Among the diabetic women with antiphospholipid antibodies the duration of disease was five years or more. Maternal age in positive antiphospholipid antibodies diabetics ranged from 27 to 38 years; one was primiparous, another was secundiparous and two were multiparous. CONCLUSION: antiphospholipid antibodies prevalence in diabetic pregnant women was similar to that in the general population and lower than that of the pregestational diabetic women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(3):179-183
DOI 10.1590/S0100-72032006000300007
PURPOSE: to diagnose and treat diabetic pregnant women with antiphospholipid antibodies and to describe the gestational and perinatal results. METHODS: we evaluated 56 gestational and pregestational diabetic women who were attended at one specialized prenatal care unit, between July 2003 and March 2004. All of them had a blood test to quantify antiphospholipid antibodies. If positive, they were treated with heparin and aspirin at low doses and the usual treatment for diabetes. We calculated the prevalence and 95% confidence interval for all and also those for the pregestational ones. The characteristics of the pregnancies and the newborns are described. RESULTS: antiphospholipid antibodies prevalence among the diabetic pregnant women was 7% (95% CI - 0.1 to 13.9). Among pregestational diabetic women it was 12% (95% CI - 0.2 to 23.3). Among the diabetic women with antiphospholipid antibodies the duration of disease was five years or more. Maternal age in positive antiphospholipid antibodies diabetics ranged from 27 to 38 years; one was primiparous, another was secundiparous and two were multiparous. CONCLUSION: antiphospholipid antibodies prevalence in diabetic pregnant women was similar to that in the general population and lower than that of the pregestational diabetic women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(2):101-106
DOI 10.1590/S0100-72032000000200007
Purpose: to evaluate the prevalence of anticardiolipin antibody in women with stillbirth. Patients and Methods: this was a cross-sectional study performed from May 1998 to September 1999 at the Maternity of the University of Campinas and at the Hospital and Maternity Leonor Mendes de Barros, in Brazil, which evaluated 109 pregnant women hospitalized with the diagnosis of intrauterine fetal death and gestational age of 20 or more weeks. These women underwent some laboratory examinations to identify the cause of fetal death, including anticardiolipin antibody evaluation performed through the determination of IgG and IgM serum levels. IgG and IgM results are expressed as GPL and MPL units, respectively, and, in both cases, results above 10 units are considered positive. The statistical procedures used were the mean and standard deviation estimates, Student's t test, Fisher test and chi². Results: the prevalence of anticardiolipin positivity was 18.3%. The women were predominantly young, with a mean age around 27 years. The main identified causes of fetal death were: hypertension (26.1%), hemorrhage during the third trimester (9.9%) and fetal malformation (8.1%). One third of the cases had no identified causes of fetal death. However, considering the 20 positive cases for anticardiolipin antibody, the proportion of unidentified causes decreased to 29%. Conclusions: it is important to investigate the presence of anticardiolipin antibodies among women with intrauterine fetal death with the purpose of clarifying the causes of stillbirth. If the diagnosis of antiphospholipid syndrome is confirmed, it is necessary to counsel and treat these women regarding future pregnancies.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(2):101-106
DOI 10.1590/S0100-72032000000200007
Purpose: to evaluate the prevalence of anticardiolipin antibody in women with stillbirth. Patients and Methods: this was a cross-sectional study performed from May 1998 to September 1999 at the Maternity of the University of Campinas and at the Hospital and Maternity Leonor Mendes de Barros, in Brazil, which evaluated 109 pregnant women hospitalized with the diagnosis of intrauterine fetal death and gestational age of 20 or more weeks. These women underwent some laboratory examinations to identify the cause of fetal death, including anticardiolipin antibody evaluation performed through the determination of IgG and IgM serum levels. IgG and IgM results are expressed as GPL and MPL units, respectively, and, in both cases, results above 10 units are considered positive. The statistical procedures used were the mean and standard deviation estimates, Student's t test, Fisher test and chi². Results: the prevalence of anticardiolipin positivity was 18.3%. The women were predominantly young, with a mean age around 27 years. The main identified causes of fetal death were: hypertension (26.1%), hemorrhage during the third trimester (9.9%) and fetal malformation (8.1%). One third of the cases had no identified causes of fetal death. However, considering the 20 positive cases for anticardiolipin antibody, the proportion of unidentified causes decreased to 29%. Conclusions: it is important to investigate the presence of anticardiolipin antibodies among women with intrauterine fetal death with the purpose of clarifying the causes of stillbirth. If the diagnosis of antiphospholipid syndrome is confirmed, it is necessary to counsel and treat these women regarding future pregnancies.