Perinatal outcomes in indian women with Antiphospholipid Antibody Syndrome (APS): Five year experience from a tertiary care centre
Background: Antiphospholipid Syndrome (APS) is a systemic autoimmune thrombophilic condition characterized by obstetric manifestations, including pregnancy loss, preeclampsia and fetal growth restriction. Early diagnosis and management are key to improve maternal and neonatal outcomes. Objective: Th...
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Elsevier
2024-12-01
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| Series: | European Journal of Obstetrics & Gynecology and Reproductive Biology: X |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590161324000607 |
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| author | Minakshi Rohilla Mahak Bhardwaj Vanita Jain |
| author_facet | Minakshi Rohilla Mahak Bhardwaj Vanita Jain |
| author_sort | Minakshi Rohilla |
| collection | DOAJ |
| description | Background: Antiphospholipid Syndrome (APS) is a systemic autoimmune thrombophilic condition characterized by obstetric manifestations, including pregnancy loss, preeclampsia and fetal growth restriction. Early diagnosis and management are key to improve maternal and neonatal outcomes. Objective: The aim of this study is to assess the perinatal outcomes in APS, the development of various adverse pregnancy outcomes (APO), and their association with specific antibody profiles. Material methods: This observational study was carried out on booked cases of singleton pregnancy and diagnosed cases of primary APS in our High-Risk Pregnancy (HRP) clinic from January 2018 to December 2022 after approval from institutional ethics committee. Forty-three confirmed cases of primary APS were enrolled and started on low-dose aspirin and low-molecular-weight heparin (LMWH) as per the patient's body weight after confirmation of fetal heart activity radiologically until 36 weeks of gestation as a standard of care. Results: Forty patients (93 %) had obstetric APS, and three patients (7 %) had thrombotic APS. During the course of the current pregnancy, adverse pregnancy outcomes (APO) developed in 12 (30 %) out of 40 cases of obstetric APS and in all 3 patients with thrombotic APS. Preeclampsia was seen in 11 (25.5 %), FGR in 12 (27.9 %), and preterm birth in 7 (16.2 %) cases. Patients with an antibody profile showing the presence of Anti-β2 GP-I positivity and ACL positivity had fewer APOs (20 % and 29 %) in comparison to patients with a LA and triple positive antibody profile (55 % and 50 %). Conclusion: Treatment of pregnant women with APS causes significant improvement in the live birth rate. The late pregnancy complications like preeclampsia, FGR, and premature birth, occurring despite treatment still remains a challenge and emphasizes the need for stringent antepartum surveillance and timely delivery. |
| format | Article |
| id | doaj-art-e884cdc693cb487b96211179a20d477a |
| institution | OA Journals |
| issn | 2590-1613 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | European Journal of Obstetrics & Gynecology and Reproductive Biology: X |
| spelling | doaj-art-e884cdc693cb487b96211179a20d477a2025-08-20T01:55:27ZengElsevierEuropean Journal of Obstetrics & Gynecology and Reproductive Biology: X2590-16132024-12-012410034010.1016/j.eurox.2024.100340Perinatal outcomes in indian women with Antiphospholipid Antibody Syndrome (APS): Five year experience from a tertiary care centreMinakshi Rohilla0Mahak Bhardwaj1Vanita Jain2Department of Obstetrics and Gynaecology, PGIMER Chandigarh, 160012, IndiaCorresponding author.; Department of Obstetrics and Gynaecology, PGIMER Chandigarh, 160012, IndiaDepartment of Obstetrics and Gynaecology, PGIMER Chandigarh, 160012, IndiaBackground: Antiphospholipid Syndrome (APS) is a systemic autoimmune thrombophilic condition characterized by obstetric manifestations, including pregnancy loss, preeclampsia and fetal growth restriction. Early diagnosis and management are key to improve maternal and neonatal outcomes. Objective: The aim of this study is to assess the perinatal outcomes in APS, the development of various adverse pregnancy outcomes (APO), and their association with specific antibody profiles. Material methods: This observational study was carried out on booked cases of singleton pregnancy and diagnosed cases of primary APS in our High-Risk Pregnancy (HRP) clinic from January 2018 to December 2022 after approval from institutional ethics committee. Forty-three confirmed cases of primary APS were enrolled and started on low-dose aspirin and low-molecular-weight heparin (LMWH) as per the patient's body weight after confirmation of fetal heart activity radiologically until 36 weeks of gestation as a standard of care. Results: Forty patients (93 %) had obstetric APS, and three patients (7 %) had thrombotic APS. During the course of the current pregnancy, adverse pregnancy outcomes (APO) developed in 12 (30 %) out of 40 cases of obstetric APS and in all 3 patients with thrombotic APS. Preeclampsia was seen in 11 (25.5 %), FGR in 12 (27.9 %), and preterm birth in 7 (16.2 %) cases. Patients with an antibody profile showing the presence of Anti-β2 GP-I positivity and ACL positivity had fewer APOs (20 % and 29 %) in comparison to patients with a LA and triple positive antibody profile (55 % and 50 %). Conclusion: Treatment of pregnant women with APS causes significant improvement in the live birth rate. The late pregnancy complications like preeclampsia, FGR, and premature birth, occurring despite treatment still remains a challenge and emphasizes the need for stringent antepartum surveillance and timely delivery.http://www.sciencedirect.com/science/article/pii/S2590161324000607Antiphospholipid antibodyThrombophiliaLow molecular weight heparin (lmwh)Adverse pregnancy-fetal outcomesPre-eclampsia |
| spellingShingle | Minakshi Rohilla Mahak Bhardwaj Vanita Jain Perinatal outcomes in indian women with Antiphospholipid Antibody Syndrome (APS): Five year experience from a tertiary care centre European Journal of Obstetrics & Gynecology and Reproductive Biology: X Antiphospholipid antibody Thrombophilia Low molecular weight heparin (lmwh) Adverse pregnancy-fetal outcomes Pre-eclampsia |
| title | Perinatal outcomes in indian women with Antiphospholipid Antibody Syndrome (APS): Five year experience from a tertiary care centre |
| title_full | Perinatal outcomes in indian women with Antiphospholipid Antibody Syndrome (APS): Five year experience from a tertiary care centre |
| title_fullStr | Perinatal outcomes in indian women with Antiphospholipid Antibody Syndrome (APS): Five year experience from a tertiary care centre |
| title_full_unstemmed | Perinatal outcomes in indian women with Antiphospholipid Antibody Syndrome (APS): Five year experience from a tertiary care centre |
| title_short | Perinatal outcomes in indian women with Antiphospholipid Antibody Syndrome (APS): Five year experience from a tertiary care centre |
| title_sort | perinatal outcomes in indian women with antiphospholipid antibody syndrome aps five year experience from a tertiary care centre |
| topic | Antiphospholipid antibody Thrombophilia Low molecular weight heparin (lmwh) Adverse pregnancy-fetal outcomes Pre-eclampsia |
| url | http://www.sciencedirect.com/science/article/pii/S2590161324000607 |
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