Monitoring obstetric antiphospholipid syndrome

Pregnancy morbidity is a well-recognized presentation of antiphospholipid syndrome (APS), which is part of the classification criteria. Obstetric APS responsible for causing great emotional impacts due to pregnancy loss that causes and financial impacts due to increased gestational morbidly. Recurrent early miscarriages (excluding chromosomal anomalies), late fetal loss, and maternal thrombosis are characteristic of obstetric antiphospholipid syndrome (APS). Obstetric complications such as preeclampsia, fetal growth restriction, premature delivery, and fetal death also occur in higher frequency in APS patients than in general population. A high-risk obstetric center is needed for proper evaluation of and intervention with pregnant women with APS. Association with lupus carries additional risk of thrombosis when antiphospholipid antibodies (aPLs) are present. Gestational results with live births are improved to about 80% when antithrombotic therapy is used, but failure in 20% to 30% of the cases despite correct treatment with low dose aspirin with or without heparin reveals new pathways for pregnancy loss in APS and unmet needs. In this article, we will review how medications interfere in the pathogenic mechanisms of APS and discuss the impact of current recommended treatment on pregnancy morbidity.Keywords: Antiphospholipid syndrome; Recurrent abortion; Thrombosis.A morbidade gestacional e uma forma bem reconhecida de apresentacao da sindrome antifosfolipideo (SAF), que e parte do criterio de classificacao. A SAF obstetrica e responsavel por causar grandes impactos emocionais devido as perdas gestacionais que ocasiona e impactos financeiros em virtude do aumento da morbidade gestacional. Depois do diagnostico apropriado, o tratamento de pacientes com SAF gera um aumento significativo na taxa de nascidos vivos, embora o risco de outras morbidades obstetricas, como pre-eclampsia, restricao de crescimento fetal (CIUR) e prematuridade permanecam altas. Abortamentos recorrentes do primeiro trimestre (excluindo anomalias cromossomicas), perda fetal tardia, e trombose materna sao caracteristicas da sindrome antifosfolipideo obstetrica (SAF). Complicacoes obstetricas como pre-eclampsia, restricao de crescimento fetal, parto prematuro e obito fetal tambem ocorrem com mais frequencia em pacientes com SAF do que na populacao geral. O acompanhamento e a eventual intervencao em gestantes com SAF devem ocorrer em um Centro de referencia em gestacoes de alto risco. A ass