Recurrent pregnancy loss and association with anti phospho lipid syndrome
Abstract
SUMMARY
Recurrent miscarriage, the occurrence of three consecutive first-trimester losses of pregnancy, affects 1-3 % of pregnant women. The purported causes of recurrent miscarriage include chromosomal abnormalities, thrombophilia, metabolic disorders, anatomical and immunological disturbances. At present, the only recommended investigations are testing for lupus anticoagulant and anticardiolipin antibody levels to diagnose the antiphospholipid syndrome, an acquired thrombophilia and the karyotyping of both parents for chromosomal abnormalities. The Antiphospholipid Syndrome (APS) is an autoimmune disorder characterized by thrombosis, recurrent loss of pregnancy combined with laboratory tests that indicate the presence of antibodies against phospholipid binding proteins.Clinically relevant antiphospholipid antibodies are mainly anticardiolipin antibodies detected by enzyme linked immuno sorbent assay (ELISA) and lupus anticoagulants demonstrated by in vitro coagulation assay. Women with antiphospholipid syndrome should be offered treatment with aspirin and low subcutaneous heparin. We aimed to summarize current concepts on diagnosis and treatment in recurrent loss of pregnancies and APS.
Recurrent miscarriage, the occurrence of three consecutive first-trimester losses of pregnancy, affects 1-3 % of pregnant women. The purported causes of recurrent miscarriage include chromosomal abnormalities, thrombophilia, metabolic disorders, anatomical and immunological disturbances. At present, the only recommended investigations are testing for lupus anticoagulant and anticardiolipin antibody levels to diagnose the antiphospholipid syndrome, an acquired thrombophilia and the karyotyping of both parents for chromosomal abnormalities. The Antiphospholipid Syndrome (APS) is an autoimmune disorder characterized by thrombosis, recurrent loss of pregnancy combined with laboratory tests that indicate the presence of antibodies against phospholipid binding proteins.Clinically relevant antiphospholipid antibodies are mainly anticardiolipin antibodies detected by enzyme linked immuno sorbent assay (ELISA) and lupus anticoagulants demonstrated by in vitro coagulation assay. Women with antiphospholipid syndrome should be offered treatment with aspirin and low subcutaneous heparin. We aimed to summarize current concepts on diagnosis and treatment in recurrent loss of pregnancies and APS.
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