How does APS affect pregnancy outcomes

How does APS affect pregnancy outcomes? How it is best treated?

• Patients with APS with or without SLE are at risk for poor pregnancy outcomes (OR 9.2) including intrauterine growth restriction (OR 4.7), preeclampsia (OR 2.3), thrombosis (OR 12.1), and early and late fetal loss.

• A systematic review found that for recurrent early miscarriage associated with APS, the addition of heparin plus ASA provided an estimated 54% reduced risk of pregnancy loss. No universally accepted guidelines exist for prophylaxis in pregnancy with persistently positive antibodies. Most determine treatment based on prior manifestations of pregnancy-associated APS. It is recommended to start ASA 4 weeks prior to conception if possible. See Table 78.5 for additional details regarding treatment for pregnancy-associated APS.


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