Primary antiphospholipid syndrome: therapeutic management during pregnancy

Abstract

Objective: To test hypothesis that plasmapheresis could be effective in complex therapy of primary antiphospholipid syndrome in women with recurrent pregnancy losses during pregnancy.

Full Text

Methods: We studied 156 pregnant women with primary anti phospholipid syndrome and recurrent pregnancy losses. Tests to detect LA, including the activated partial thromboplastin time (APTT), the kaolin clotting time, were performed.

Results: Positive results were found in all pregnant women with associated clinical complications. In the first group (81 patients) we used immunosuppressive drugs in low doses - prednisone (5-10 mg/day) or methipred (4-8 mg/day) combined with low-dose aspirin (100 mg/day) and, if necessary - anticoagulant treatment subcutaneous heparin. In the second group (75 cases) we used corticoids, aspirin and plasmapheresis 3 times during pregnancy. 8/81 (9,8%) pregnancies in the first group and 5/75 (6,6%) in the second group terminated as preterm labor on 32-34 weeks of gestation. After 3 session of plasmapheresis it was noted absence of LA in venous blood in 65/75 (86,7%) of patients. Normalization of haemostasiogramm (decrease of thrombodynamic potential index), plateletys aggregation, disappearance of DIC markers was noted in 70/75 (93,3%) of patients. Successful pregnancies have been obtained in 67/75 (89,3%) cases.

Conclusion: Plasmapheresis may be effective in complex therapy of primary anti phospholipid syndrome in patients with recurrent pregnancy losses.