Recommendations for diagnosis and treatment planning, and treatment during the pregnancy, postpartum and breastfeeding period in patients with antiphospholipid syndrome

• Main Authors: Lidia Ostanek, Maria Majdan, Marzena Olesińska, Mariola Kosowicz, Justyna Teliga-Czajkowska, Piotr Wiland
• Format: Article
• Language: English
• Published: Termedia Publishing House 2014-03-01
• Series: Rheumatology
• Subjects: antiphospholipid syndrome; pregnancy; postpartum; breastfeeding; treatment
• Online Access: http://www.termedia.pl/Recommendations-for-diagnosis-and-treatment-planning-and-treatment-during-the-pregnancy-postpartum-and-breastfeeding-period-in-patients-with-antiphospholipid-syndrome,18,22450,1,1.html

The antiphospholipid syndrome (APS) is an interdisciplinary condition with a clinical picture in which thrombotic complications and obstetric failures play the most significant role. It has been demonstrated on the basis of multicentre clinical observations that the most common pregnancy-related complications in the course of APS include: recurrent miscarriage in the first trimester of pregnancy, pregnancy loss in the second and third trimester of pregnancy, early preeclampsia and preterm delivery. Any APS female patient planning a pregnancy should be advised about the risk of complications which may occur in the course of pregnancy. The treatment of pregnant APS patients should be conducted by a multidisciplinary team including specialists in rheumatology, obstetrics, and in justified cases also in haematology. The most important element of the pregnant APS patient management is secondary thromboprophylaxis with low dose aspirin and heparins. The introduction of hydroxychloroquine is recommended in patients with systemic lupus erythematosus. The visits should take place every 4 weeks and starting from week 26–28 of pregnancy every 1–2 weeks. The patients should be strictly monitored for signs of preeclampsia and/or thrombosis.