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Antiphospholipid in obstetric patient

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https://www.readbyqxmd.com/read/29130759/preeclampsia-in-pregnancies-complicated-by-sle-nephritis-prophylactic-treatment-with-multidisciplinary-approach-are-important-keys-to-prevent-adverse-obstetrics-outcomes
#1
Federico Mecacci, Serena Simeone, Calogero Lino Cirami, Mauro Cozzolino, Caterina Serena, Marianna Pina Rambaldi, Pamela Gallo, Lorenzo Emmi, Daniele Cammelli, Giorgio Mello, Marco Matucci Cerinic
INTRODUCTION: Systemic lupus erythematosus (SLE) commonly affects women of childbearing age. Hypertension, antiphospholipid syndrome and lupus nephritis are risk factors for adverse maternal/fetal outcome. The aim of this retrospective cohort study is to compare pregnancy outcomes in patients with and without SLE nephritis, using a multidisciplinary approach and a broad prophylaxis protocol. MATERIALS AND METHODS: Data were collected from 86 pregnancies complicated by SLE...
November 12, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29113876/-indirect-causes-of-maternal-deaths-except-stroke-cardiovascular-diseases-and-infections-results-from-the-french-confidential-enquiry-into-maternal-deaths-2010-2012
#2
V Le Guern, M Rossignol, A Proust
Maternal deaths of indirect causes result of a preexisting disease or an affection appeared during the pregnancy without any relationship with obstetrical causes, but worsened by the physiological effects of pregnancy. Among the 23 deaths of indirect cause related to a preexisiting pathology, 22 (96 %) have been analyzed by the expert comity. A known or preexisting chronic disease was documented in 16 patients (sick-cell disorder, n=3, treated epilepsy, n=3, intracerebral carvenomas, n=1, multifocal glial tumor, n=1, breast cancer, n=1, systemic lupus, n=1, diabetes mellitus, n=3, antiphospholipid syndrome, n=1)...
November 4, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29068782/analysis-of-the-cause-of-recurrent-pregnancy-loss-in-vietnam-a-cross-sectional-study
#3
Thi Anh Dao Le, Duy Anh Nguyen, Thanh Van Ta, Van Minh Hoang
Recurrent pregnancy loss is a physical and mental burden for women.  In Vietnam, exploring the cause of miscarriages is still a challenge to clinical physicians. We aimed to investigate the etiology of recurrent pregnancy loss in a national hospital of obstetrics and gynecology in Vietnam from 2012 to 2014. The cross-sectional study included 301 pregnant women with a history of recurrent pregnancy loss. The patients were examined and offered medical testing to determine cause(s). Based on testing we determined causation for (11...
October 25, 2017: Health Care for Women International
https://www.readbyqxmd.com/read/29027631/detrimental-roles-of-tnf-alpha-in-the-antiphospholipid-syndrome-and-de-novo-synthesis-of-antiphospholipid-antibodies-induced-by-biopharmaceuticals-against-tnf-alpha
#4
REVIEW
Mirjana Bećarević
Antiphospholipid syndrome (APS) is an autoimmune disease that is characterized by arterial and/or venous thrombosis and/or recurrent pregnancy losses. Obstetric APS (OAPS) is considered as a distinct entity from vascular APS (VAPS). In the absence of any additional disease, APS is designated as primary (PAPS), while the term secondary APS (SAPS) is used when other diseases are associated. Catastrophic APS (CAPS) is characterized by the rapid development of multiple thrombosis in various vital organs. The presence of antiphospholipid antibodies (aPL Abs) is considered as a laboratory criterion for APS diagnosis...
November 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28993281/two-miscarriages-consecutive-or-non-consecutive-does-it-change-something
#5
C Cardinale, J Berbis, C Chau, F Bernard, D Arnoux, M-F Fratacci, L Boubli, F Bretelle
OBJECTIVES: To assess the rate of anomalies in the etiological evaluation of patients presenting recurrent early miscarriages (RM) according to miscarriage chronology (number of miscarriages, history of live birth and succession of RM). METHODS: Retrospective single centre study including RM, defined as at least 2 miscarriages at less than 14 weeks of gestation (WG) between the 1st January 2012 and the 31st December 2015. Clinical data and etiological evaluation include blood glucose levels, screening for antiphospholipid syndrome (APS), endocrine assessment, vitamin levels, pelvic imaging, karyotyping of both partners, chronic endometritis and thrombophilia screening...
October 6, 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28948358/pregnancy-outcome-in-162-women-with-rheumatic-diseases-experience-of-a-university-hospital-in-turkey
#6
Ebru Alici Davutoğlu, Aysegul Ozel, Nevin Yılmaz, Riza Madazli
PURPOSE: To evaluate the distribution and the obstetric outcomes of pregnancies with different types of rheumatic diseases managed in our unit. METHODS: Pregnancies of 162 women with rheumatic diseases, seen for their antenatal care at our department for the period between 2013 and 2017 were included in this retrospective clinical study. Obstetric and perinatal outcomes were main outcome measures. RESULTS: The most encountered rheumatic diseases were SLE (37...
December 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28915160/current-insights-in-obstetric-antiphospholipid-syndrome
#7
Karen Schreiber, Massimo Radin, Savino Sciascia
PURPOSE OF REVIEW: Antiphospholipid syndrome (APS) is defined as the association of thrombotic events and/or obstetric morbidity in patients persistently positive for antiphospholipid antibodies (aPL). In this review, we will highlight the most important clinical presentations of APS with a focus on the obstetric morbidity, the current management strategies and the outlook for the future. RECENT FINDINGS: The use of aspirin and heparin has improved the pregnancy outcome in obstetric APS and approximately 70% of pregnant women with APS have a successful pregnancy outcome...
December 2017: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28829758/catastrophic-antiphospholipid-syndrome-ronald-asherson-syndrome-and-obstetric-pathology
#8
Alexander D Makatsariya, Jamilya Khizroeva, Viktoriya O Bitsadze
BACKGROUND: Catastrophic antiphospholipid syndrome (CAPS) is an uncommon, often fatal, variant of the antiphospholipid syndrome (APS) that results in a widespread coagulopathy and high titres of antiphospholipid antibodies (aPL) and affects predominantly small vessels supplying organs with the development of multiorgan failure. It remains unclear why some patients develop the typical clinical picture of APS (thrombosis of large vessels), whereas others show the development of progressive microthrombosis, which the authors called "thrombotic storm" and multiple organ failure, that is, CAPS...
August 22, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28748519/obstetric-antiphospholipid-syndrome-and-long-term-arterial-thrombosis-risk
#9
Genady Drozdinsky, Eran Hadar, Anat Shmueli, Rinat Gabbay-Benziv, Shachaf Shiber
Antiphospholipid syndrome (APS) is classified as the association of a thrombotic event and/or obstetric morbidity in patients persistently positive for antiphospholipid antibodies and/or lupus anticoagulant. To evaluate the incidence of subsequent thrombosis among women diagnosed with purely obstetric APS. We retrospectively reviewed and collected demographic and clinical data from the computerized charts of all patients with obstetric APS, from 1992 to 2017. Eligibility criteria included all women diagnosed with APS, according to the 2006 revised criteria, for whom the clinical manifestations were purely obstetric...
October 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28680464/-to-test-or-not-to-test-the-arguments-for-and-against-thrombophilia-testing-in-obstetrics
#10
REVIEW
Laura Ormesher, Louise E Simcox, Clare Tower, Ian A Greer
Clinicians increasingly investigate women for thrombophilias due to their associations with venous thromboembolism and placenta-mediated pregnancy complication. These associations, however, are modest and based largely on retrospective data from studies with heterogeneous classifications and populations, leading to discordance between evidence and guidelines. Current evidence suggests a contributory rather than causative role for thrombophilia in placenta-mediated pregnancy complication and venous thromboembolism...
June 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28647939/non-criteria-or-seronegative-obstetric-antiphospholipid-syndrome
#11
REVIEW
Luis J Jara, Gabriela Medina, Polita Cruz-Cruz, Javier Olivares-Rivera, Carolina Duarte-Salazar, Miguel A Saavedra
Obstetric antiphospholipid syndrome (Obs-APS) is one of the most commonly identified causes of recurrent pregnancy loss and its accurate diagnosis is a requirement for optimal treatment. Some patients do not fulfill the revised Sapporo classification criteria, the original APS classification criteria, and are considered to be non-criteria Obs-APS. In these patients with non-criteria, there is controversy about their inclusion within the spectrum of APS and eventually their treatment as having Obs-APS. A subset of patients may also have clinical characteristics of Obs-APS even though lupus anticoagulant (LA), anticardiolipin antibodies, and anti-β2-glycoprotein I (aβ2GPI) antibodies are consistently negative...
June 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28576307/serological-evolution-in-women-with-positive-antiphospholipid-antibodies
#12
Leyre Riancho-Zarrabeitia, Germán Daroca, Pedro Muñoz, Marcos López-Hoyos, Ana Haya, Víctor M Martínez-Taboada
OBJECTIVES: To explore the clinical and serological course of fertile women with positive antiphospholipid (aPL), and the factors and therapeutic implications associated with aPL negativization. METHODS: Retrospective study including 105 women with a positive aPL serology between 1995 and 2013 attending the obstetric autoimmune pathology clinic of a tertiary facility. Patients were classified into the following 3 groups: patients with primary antiphospholipid syndrome (pAPS, 49), patients with a positive serology for aPL, not meeting clinical criteria (42), and patients with systemic lupus erythematosus and a positive aPL serology (14)...
May 10, 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/28572466/longterm-outcome-of-patients-with-primary-antiphospholipid-syndrome-a-retrospective-multicenter-study
#13
Mara Taraborelli, Rossella Reggia, Francesca Dall'Ara, Micaela Fredi, Laura Andreoli, Maria Gerosa, Ariela Hoxha, Laura Massaro, Marta Tonello, Nathalie Costedoat-Chalumeau, Patrice Cacoub, Franco Franceschini, Pier Luigi Meroni, Jean Charles Piette, Amelia Ruffatti, Guido Valesini, Eon Nigel Harris, Angela Tincani
OBJECTIVE: To assess the longterm frequency of thrombotic recurrences, obstetrical complications, organ damage, severe comorbidities, and evolution toward connective tissue disease (CTD) in primary antiphospholipid syndrome (PAPS). METHODS: Medical records of patients with PAPS followed in 6 centers for ≥ 15 years were retrospectively reviewed. RESULTS: One hundred fifteen patients were studied: 88% women, followed between 1983 and 2014 with a mean (± SD) age at diagnosis of 33 (± 10) years...
August 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28532221/antiphospholipid-antibodies-are-associated-with-positive-screening-for-common-mental-disorders-in-women-with-previous-pregnancy-loss-the-noha-psy-observational-study
#14
Jean-Christophe Gris, Fabienne Cyprien, Sylvie Bouvier, Eva Cochery-Nouvellon, Géraldine Lavigne-Lissalde, Erick Mercier, Jean-Pierre Balducchi
OBJECTIVES: Case reports describe neuropsychiatric manifestations associated with antiphospholipid antibodies (aPlAbs). In patients sharing the same symptoms fulfilling the antiphospholipid syndrome (APS) clinical criteria, the prevalence of common mental disorders has, however, never been studied. METHODS: We observed women with three consecutive abortions before the 10th week of gestation or one foetal loss at or beyond the 10th week. We compared the prevalence of common psychiatric disorders detected through screening using the Mini International Neuropsychiatric Interview, 10 years after inclusion, in women with APS (n = 506), women negative for aPlAbs but carrying the F5rs6025 or F2rs1799963 thrombogenic polymorphism (n = 269), and women with negative thrombophilia screening results as controls (n = 764)...
June 19, 2017: World Journal of Biological Psychiatry
https://www.readbyqxmd.com/read/28476065/extracellular-vesicles-in-the-antiphospholipid-syndrome
#15
Shruti Chaturvedi, Ravi Alluri, Keith R McCrae
Antiphospholipid antibodies (aPL), particularly those directed against β2-glycoprotein I, cause activation of vascular cells (endothelial cells, platelets, monocytes) and release of extracellular vesicles (EVs), which include exosomes and microparticles (MPs). MPs, particularly endothelial MPs, have been most extensively studied in antiphospholipid syndrome (APS). Compared with healthy controls, patients with aPL have significantly higher levels of circulating endothelial and platelet MPs, including MPs expressing immunological and functional tissue factor...
May 5, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28473138/antiphospholipid-syndrome-role-of-vascular-endothelial-cells-and-implications-for-risk%C3%A2-stratification-and-targeted-therapeutics
#16
REVIEW
Michel T Corban, Ali Duarte-Garcia, Robert D McBane, Eric L Matteson, Lilach O Lerman, Amir Lerman
Antiphospholipid syndrome (APS) is an autoimmune disease characterized by venous thromboembolism, arterial thrombosis, and obstetric morbidities in the setting of persistently positive levels of antiphospholipid antibodies measured on 2 different occasions 12 weeks apart. Patients with APS are at increased risk for accelerated atherosclerosis, myocardial infarction, stroke, and valvular heart disease. Vascular endothelial cell dysfunction mediated by antiphospholipid antibodies and subsequent complement system activation play a cardinal role in APS pathogenesis...
May 9, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28471597/women-s-issues-in-antiphospholipid-syndrome
#17
Emmanouil Papadakis, Anastasia Banti, Anna Kioumi
Antiphospholipid syndrome (APS) is an autoimmune systemic disease characterized by vascular thrombosis (arterial or venous) and/or pregnancy complications associated with the occurrence of autoantibodies, specifically lupus anticoagulant, anticardiolipin antibodies, and/or anti-β2 glycoprotein-I antibodies confirmed at least twice over a 12 week period according to the 2006 Sydney criteria. Antiphospholipid antibodies are encountered  in the general population with a reported prevalence of 1% to 5%  However, APS is far more infrequent with a prevalence of 40-50/100,000 persons and an incidence of about 5 new patients/100,000 persons...
September 2016: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28467291/clinical-associations-of-proinflammatory-cytokines-oxidative-biomarkers-and-vitamin-d-levels-in-systemic-lupus-erythematosus
#18
R Willis, M Smikle, K DeCeulaer, Z Romay-Penabad, E Papalardo, P Jajoria, B Harper, V Murthy, M Petri, E B Gonzalez
Background The abnormal biological activity of cytokines plays an important role in the pathophysiology of both systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS). Several studies have highlighted the association of vitamin D and certain pro-inflammatory cytokines with disease activity in SLE. However, there are limited data on the association of vitamin D and antiphospholipid antibodies (aPL) with various proinflammatory biomarkers in these patients and their relative impact on clinical outcomes...
December 2017: Lupus
https://www.readbyqxmd.com/read/28424481/the-first-genome-wide-association-study-identifying-new-susceptibility-loci-for-obstetric-antiphospholipid-syndrome
#19
Mayumi Sugiura-Ogasawara, Yosuke Omae, Minae Kawashima, Licht Toyo-Oka, Seik-Soon Khor, Hiromi Sawai, Tetsuya Horita, Tatsuya Atsumi, Atsuko Murashima, Daisuke Fujita, Tomio Fujita, Shinji Morimoto, Eriko Morishita, Shinji Katsuragi, Tamao Kitaori, Kinue Katano, Yasuhiko Ozaki, Katsushi Tokunaga
Antiphospholipid syndrome (APS) is the most important treatable cause of recurrent pregnancy loss. The live birth rate is limited to only 70-80% in patients with APS undergoing established anticoagulant therapy. Lupus anticoagulant (LA), but not anticardiolipin antibody (aCL), was found to predict adverse pregnancy outcome. Recent genome-wide association studies (GWAS) of APS focusing on aCL have shown that several molecules may be involved. This is the first GWAS for obstetric APS focusing on LA. A GWAS was performed to compare 115 Japanese patients with obstetric APS, diagnosed according to criteria of the International Congress on APS, and 419 healthy individuals...
September 2017: Journal of Human Genetics
https://www.readbyqxmd.com/read/28401195/live-birth-pregnancy-outcome-after-first-in-vitro-fertilization-treatment-in-a-patient-with-systemic-lupus-erythematosus-and-isolated-high-positive-iga-anti-%C3%AE-2glycoprotein-i-antibodies-a-case-report
#20
Hristina Andreeva, Marit Seip, Stanislava Koycheva
IgA anti-β2glycoprotein I antibodies (IgA-anti-β2GPI) seems to be the most prevalent isotype in patients with Systemic Lupus Erythematosus (SLE) with a significant association to thrombotic events. Both SLE and antiphospholipid syndrome (APS) can be associated with implantation failure, fetal loss and obstetric complications. Recent reports highlight the clinical value of IgA-anti-β2GPI determination in supporting in vitro fertilization (IVF) treatment and IVF pregnancy outcomes. We report a 36-year-old female diagnosed with SLE, endometriosis and unexplained infertility...
January 2017: Open Medicine (Warsaw, Poland)
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