gynecology and obstetrics medical project, gynecology journal, obstetrics, gynecologic oncology, reproductive medicine, gynecological endoscopy, ultrasonography, gynecology articles

Ginekologia i Poloznictwo
ISSN 1896-3315 e-ISSN 1898-0759

Antiphospholipid syndrome (APS) in present-day obstetrics


Author(s): Jerzy Heimrath, Barbara Grześ

The Reproductive Autoimmune Failure Syndrome belongs to relatively recent terminology. The basis for its diagnosing is finding an autoimmune disease in subclinical stage, i.e. the presence of autoantibodies in women with recurrent pregnancy loss (RPL) without any distinct indicators of an autoaggressive disease. Autoimmune disturbances are the cause of about 5 – 20% of all habitual abortions; their diagnostics bases on detecting the presence of antibodies in the patients’ blood. The antiphospholipid syndrome (APS) is a non-inflammatory, systemic disease of connective tissue on autoimmune basis, with such laboratory characteristics as the presence in blood of antiphospholipid antibodies of IgG or IgM, and sometimes of IgA class, among which the most important clinically are: lupus anticoagulant (LA), anticardiolipin antibodies (ACL), and anti-ß2-GPI antibodies. The clinical characteristic of the antiphospholipid syndrome in women of reproductive age includes recurrent miscarriages, embolic and thrombotic complications, and thrombocytopenia. Presumably, antiphospholipid antibodies (APL) are the cause of a slight percentage of the disturbances of natural and in vitro fertilization. APS diagnosed in a pregnant woman involves serious obstetrical complications, such as severe pre-eclamptic state, placental insufficiency, restriction of intrauterine fetal growth, imminent fetal asphyxia and premature birth for iatrogenic reasons. The presence of these antibodies underlies numerous puerperal complications, such as cerebral and pulmonary embolism, cardiac infarct, haemolytic diseases, amnesia, and transient monocular blindness. Heparin therapy with small doses of acetylsalicylic acid prevents to a large extent miscarriages in women with APS. Further studies of the antiphospholipid syndrome are required in order to standardize tests and to explain its etiology and pathogenesis.