The management of pregnant women with antiphospholipid syndrome

Antiphospholipid syndrome (APS) is associated with several pregnancy complications as: intrauterine growth restriction, preeclampsia, premature abrubtion of the placenta as well as an increased risk of deep vein thrombosis (DVT). Treatment in this disease is still equivocal. The aim is to reduce the level of circulating antibodies and to prevent from placental thrombosis. Currently used therapeutic schemes involve aspirin and heparins – preferable low molecular weight heparins. Aspirin increases the level of prostacyclins and reduces the level of tromboksan – the platelets prothrombotic factor. Heparins, apart from their anticlotting properties, have anti-inflammatory function. Doses and duration of therapy depend on the history of thrombosis, pregnancy complications and the level of antibodies. Steroids and immunoglobulins are not routinely used, due to their side effects and high costs. In patients unresponsive to listed medications with a high risk of pregnancy loss, it is allowed to perform plasma exchange. Treatment in APS prevents from pregnancy complications and episodes of DVT in susceptible patients. Administrating in early pregnancy increases chances for life delivery to 80%.