Abstract
Author(s): Olimpia Mora-Janiszewska (AEG), Dorota DarmochwaÅ-Kolarz (AEG)
Antiphospholipid syndrome (APS) is a multisystem autoimmune disease characterized by thrombotic episodes (either arterial or venous) and/or obstetric failures with permanent positive antiphospholipid antibodies (aPLa). Pharmacological management in obstetric APS is still controversial and requires individual approach in each case. The combination of low doses of aspirin and low-molecular-weight heparin is believed to be the standard of care in pregnant women with APS and recurring miscarriages. Dosage and therapy duration depend on the obstetric history and thrombotic events in the past. Steroids and immunoglobulins are not used for APS treatment on the routine basis due to adverse events or high treatment cost. Lately, it has been proposed to administer hydroxychloroquines for obstetric APS, particularly in cases where the standard therapy has failed. However, this requires further prospective investigations so as to verify the initial observations. Pregnancy in patients with antiphospholipid syndrome must be considered a high-risk pregnancy. Maternal and fetal surveillance by a multidisciplinary team is recommended to increase chances for term pregnancy and delivery of a healthy child.