The Antiphospholipid Syndrome - Important Cause of Thrombotic Events in Pregnancy

摘要

The antiphospholipid syndrome(APLS) is a thrombotic condition marked by antibodies that recognize anionic phospholipid-protein cofactor complexes. Revision of the criteria for diagnosis of the antiphospholipid syndrome and the terminology used to describe the disease is an ongoing process (see Table l)-(l) The antiphospholipid antibodies(APLA) amplify the vascular lesions, induce the microvascular dysfunction and a prothrombotic state. (1) Women with antiphospholipid antibodies have an unusually high proportion of pregnancy losses within the fetal period (10 or more weeks of gestation) .Pregnancies in women who are positive for antiphospholipid antibodies can also be complicated by premature delivery due to pregnancy-associated hypertensive disease and uteroplacental insufficiency .Adverse pregnancy outcomes in women with the antiphospholipid syndrome may result from poor placental perfusion due to localized thrombosis, perhaps through interference with trophoblastic annexin V that is mediated by antiphospholipid antibodies. Antiphospholipid antibodies may also impair trophoblastic invasion and hormone production, thereby promoting not only preembryonic and embryonic loss but also fetal loss and uteroplacental insufficiency.(5)