Obstetric Performance in Patients with the Lupus Anticoagulant and/or Anticardiolipin Antibodies
ABSTRACT Antiphospholipid antibodies, notably the lupus anticoagulant and anticardiolipin antibodies, are associated with recurrent fetal wastage, pregnancy complications, and thromboses. Aggressive medical treatment using aspirin and steroids has been recommended. Fifty-one patients with antiphosph...
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| Veröffentlicht in: | American journal of perinatology 1992-05, Vol.9 (3), p.146-151 |
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| container_title | American journal of perinatology |
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| creator | Landy, Helain J. Kessler, Craig Kelly, William K. Weingold, Allan B. |
| description | ABSTRACT
Antiphospholipid antibodies, notably the lupus anticoagulant and anticardiolipin antibodies, are associated with recurrent fetal wastage, pregnancy complications, and thromboses. Aggressive medical treatment using aspirin and steroids has been recommended. Fifty-one patients with antiphospholipid antibodies, only four with underlying connective tissue disorders, were followed through 53 pregnancies. Aggressive therapy was used in 33 pregnancies, 90.9% of which resulted in successful obstetric outcomes, a highly statistically significant difference compared with previous pregnancies in the same patients. Most pregnancies among nine patients receiving single-agent therapy (aspirin or steroids alone) and eight patients not treated also had successful outcomes. A 48.6% complication rate was found in association with therapy, particularly gestational diabetes mellitus. There was no statistical correlation between dose or duration of therapy and development of treatment-related complications. Although a subgroup of patients with antiphospholipid antibodies will benefit from aggressive therapy, the high complication rate warrants close observation. |
| doi_str_mv | 10.1055/s-2007-999308 |
| format | Article |
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Antiphospholipid antibodies, notably the lupus anticoagulant and anticardiolipin antibodies, are associated with recurrent fetal wastage, pregnancy complications, and thromboses. Aggressive medical treatment using aspirin and steroids has been recommended. Fifty-one patients with antiphospholipid antibodies, only four with underlying connective tissue disorders, were followed through 53 pregnancies. Aggressive therapy was used in 33 pregnancies, 90.9% of which resulted in successful obstetric outcomes, a highly statistically significant difference compared with previous pregnancies in the same patients. Most pregnancies among nine patients receiving single-agent therapy (aspirin or steroids alone) and eight patients not treated also had successful outcomes. A 48.6% complication rate was found in association with therapy, particularly gestational diabetes mellitus. There was no statistical correlation between dose or duration of therapy and development of treatment-related complications. Although a subgroup of patients with antiphospholipid antibodies will benefit from aggressive therapy, the high complication rate warrants close observation.</description><identifier>ISSN: 0735-1631</identifier><identifier>EISSN: 1098-8785</identifier><identifier>DOI: 10.1055/s-2007-999308</identifier><identifier>PMID: 1575831</identifier><identifier>CODEN: AJPEEK</identifier><language>eng</language><publisher>New York, NY: Thieme</publisher><subject>Adrenal Cortex Hormones - therapeutic use ; Adult ; Antiphospholipid Syndrome - drug therapy ; Antiphospholipid Syndrome - epidemiology ; Aspirin - therapeutic use ; Biological and medical sciences ; Cardiolipins - immunology ; Drug Therapy, Combination ; Female ; Gynecology. Andrology. Obstetrics ; Heparin - therapeutic use ; Humans ; Lupus Coagulation Inhibitor - analysis ; Lupus Erythematosus, Systemic - drug therapy ; Lupus Erythematosus, Systemic - epidemiology ; Management. Prenatal diagnosis ; Medical sciences ; ORIGINAL ARTICLE ; Pregnancy ; Pregnancy Complications - drug therapy ; Pregnancy Complications - epidemiology ; Pregnancy Outcome - epidemiology ; Pregnancy. Fetus. Placenta</subject><ispartof>American journal of perinatology, 1992-05, Vol.9 (3), p.146-151</ispartof><rights>1992 by Thieme Medical Publishers, Inc.</rights><rights>1992 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-fb35112bbf6cfd4e91cab6c44e5d4b7fd6fe817941c9f69775b83f8281e067963</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-2007-999308.pdf$$EPDF$$P50$$Gthieme$$H</linktopdf><linktohtml>$$Uhttps://www.thieme-connect.de/products/ejournals/html/10.1055/s-2007-999308$$EHTML$$P50$$Gthieme$$H</linktohtml><link.rule.ids>314,780,784,3017,3018,27924,27925,54559,54560</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=5419990$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/1575831$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Landy, Helain J.</creatorcontrib><creatorcontrib>Kessler, Craig</creatorcontrib><creatorcontrib>Kelly, William K.</creatorcontrib><creatorcontrib>Weingold, Allan B.</creatorcontrib><title>Obstetric Performance in Patients with the Lupus Anticoagulant and/or Anticardiolipin Antibodies</title><title>American journal of perinatology</title><addtitle>Amer J Perinatol</addtitle><description>ABSTRACT
Antiphospholipid antibodies, notably the lupus anticoagulant and anticardiolipin antibodies, are associated with recurrent fetal wastage, pregnancy complications, and thromboses. Aggressive medical treatment using aspirin and steroids has been recommended. Fifty-one patients with antiphospholipid antibodies, only four with underlying connective tissue disorders, were followed through 53 pregnancies. Aggressive therapy was used in 33 pregnancies, 90.9% of which resulted in successful obstetric outcomes, a highly statistically significant difference compared with previous pregnancies in the same patients. Most pregnancies among nine patients receiving single-agent therapy (aspirin or steroids alone) and eight patients not treated also had successful outcomes. A 48.6% complication rate was found in association with therapy, particularly gestational diabetes mellitus. There was no statistical correlation between dose or duration of therapy and development of treatment-related complications. Although a subgroup of patients with antiphospholipid antibodies will benefit from aggressive therapy, the high complication rate warrants close observation.</description><subject>Adrenal Cortex Hormones - therapeutic use</subject><subject>Adult</subject><subject>Antiphospholipid Syndrome - drug therapy</subject><subject>Antiphospholipid Syndrome - epidemiology</subject><subject>Aspirin - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Cardiolipins - immunology</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Heparin - therapeutic use</subject><subject>Humans</subject><subject>Lupus Coagulation Inhibitor - analysis</subject><subject>Lupus Erythematosus, Systemic - drug therapy</subject><subject>Lupus Erythematosus, Systemic - epidemiology</subject><subject>Management. Prenatal diagnosis</subject><subject>Medical sciences</subject><subject>ORIGINAL ARTICLE</subject><subject>Pregnancy</subject><subject>Pregnancy Complications - drug therapy</subject><subject>Pregnancy Complications - epidemiology</subject><subject>Pregnancy Outcome - epidemiology</subject><subject>Pregnancy. Fetus. Placenta</subject><issn>0735-1631</issn><issn>1098-8785</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1992</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kEFv2yAYhtHUKU2zHXus5EO1U92AbQwcq2hbK0VKDtuZAf5YiGyTAVa1fz8iR92pp09878MLehC6JfiRYErXsawwZqUQosb8A1oSLHjJGadXaIlZTUvS1uQa3cR4xJhUHPMFWhDKKK_JEv3a6ZggBWeKPQTrw6BGA4Ubi71KDsYUi1eXDkU6QLGdTlMsnsbkjFe_p16NqVBjt_ZhXqrQOd-7U758PmvfOYif0Eer-gifL3OFfn77-mPzXG533182T9vSNJin0uqaElJpbVtjuwYEMUq3pmmAdo1mtmstcMJEQ4ywrWCMal5bXnECuGWirVfoy9x7Cv7PBDHJwUUDff4l-ClKVokKV5RlsJxBE3yMAaw8BTeo8FcSLM9GZZRno3I2mvm7S_GkB-j-07PCnN9fchWN6m3IAl18w2hDchHO2MOMpYODAeTRT2HMQt559R_MGozG</recordid><startdate>19920501</startdate><enddate>19920501</enddate><creator>Landy, Helain J.</creator><creator>Kessler, Craig</creator><creator>Kelly, William K.</creator><creator>Weingold, Allan B.</creator><general>Thieme</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19920501</creationdate><title>Obstetric Performance in Patients with the Lupus Anticoagulant and/or Anticardiolipin Antibodies</title><author>Landy, Helain J. ; Kessler, Craig ; Kelly, William K. ; Weingold, Allan B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-fb35112bbf6cfd4e91cab6c44e5d4b7fd6fe817941c9f69775b83f8281e067963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1992</creationdate><topic>Adrenal Cortex Hormones - therapeutic use</topic><topic>Adult</topic><topic>Antiphospholipid Syndrome - drug therapy</topic><topic>Antiphospholipid Syndrome - epidemiology</topic><topic>Aspirin - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Cardiolipins - immunology</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Heparin - therapeutic use</topic><topic>Humans</topic><topic>Lupus Coagulation Inhibitor - analysis</topic><topic>Lupus Erythematosus, Systemic - drug therapy</topic><topic>Lupus Erythematosus, Systemic - epidemiology</topic><topic>Management. Prenatal diagnosis</topic><topic>Medical sciences</topic><topic>ORIGINAL ARTICLE</topic><topic>Pregnancy</topic><topic>Pregnancy Complications - drug therapy</topic><topic>Pregnancy Complications - epidemiology</topic><topic>Pregnancy Outcome - epidemiology</topic><topic>Pregnancy. Fetus. Placenta</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Landy, Helain J.</creatorcontrib><creatorcontrib>Kessler, Craig</creatorcontrib><creatorcontrib>Kelly, William K.</creatorcontrib><creatorcontrib>Weingold, Allan B.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of perinatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Landy, Helain J.</au><au>Kessler, Craig</au><au>Kelly, William K.</au><au>Weingold, Allan B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Obstetric Performance in Patients with the Lupus Anticoagulant and/or Anticardiolipin Antibodies</atitle><jtitle>American journal of perinatology</jtitle><addtitle>Amer J Perinatol</addtitle><date>1992-05-01</date><risdate>1992</risdate><volume>9</volume><issue>3</issue><spage>146</spage><epage>151</epage><pages>146-151</pages><issn>0735-1631</issn><eissn>1098-8785</eissn><coden>AJPEEK</coden><abstract>ABSTRACT
Antiphospholipid antibodies, notably the lupus anticoagulant and anticardiolipin antibodies, are associated with recurrent fetal wastage, pregnancy complications, and thromboses. Aggressive medical treatment using aspirin and steroids has been recommended. Fifty-one patients with antiphospholipid antibodies, only four with underlying connective tissue disorders, were followed through 53 pregnancies. Aggressive therapy was used in 33 pregnancies, 90.9% of which resulted in successful obstetric outcomes, a highly statistically significant difference compared with previous pregnancies in the same patients. Most pregnancies among nine patients receiving single-agent therapy (aspirin or steroids alone) and eight patients not treated also had successful outcomes. A 48.6% complication rate was found in association with therapy, particularly gestational diabetes mellitus. There was no statistical correlation between dose or duration of therapy and development of treatment-related complications. Although a subgroup of patients with antiphospholipid antibodies will benefit from aggressive therapy, the high complication rate warrants close observation.</abstract><cop>New York, NY</cop><pub>Thieme</pub><pmid>1575831</pmid><doi>10.1055/s-2007-999308</doi><tpages>6</tpages></addata></record> |
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| subjects | Adrenal Cortex Hormones - therapeutic use Adult Antiphospholipid Syndrome - drug therapy Antiphospholipid Syndrome - epidemiology Aspirin - therapeutic use Biological and medical sciences Cardiolipins - immunology Drug Therapy, Combination Female Gynecology. Andrology. Obstetrics Heparin - therapeutic use Humans Lupus Coagulation Inhibitor - analysis Lupus Erythematosus, Systemic - drug therapy Lupus Erythematosus, Systemic - epidemiology Management. Prenatal diagnosis Medical sciences ORIGINAL ARTICLE Pregnancy Pregnancy Complications - drug therapy Pregnancy Complications - epidemiology Pregnancy Outcome - epidemiology Pregnancy. Fetus. Placenta |
| title | Obstetric Performance in Patients with the Lupus Anticoagulant and/or Anticardiolipin Antibodies |
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