The course of antiphospholipid syndrome during pregnancy and its therapy
Trofimov E.A., Trofimova A.S.

I.I. Mechnikov North-West State Medical University, St. Petersburg

The paper reviews the data on the course of the pregnancy in certain rheumatic diseases, in particular, in antiphospholipid syndrome (AFS). AFS is a systemic autoimmune disorder which is characterized by chronic increase in antiphospholipid antibody levels and manifests itself as vascular thrombosis and/or recurrent fetal loss. Antiphospholipid antibodies are a heterogeneous group antibodies reactive against phospholipids, phospholipid-binding proteins, and phospholipid-protein complexes. Antiphospholipid antibodies affect fetal growth and development during each each stage of the pregnancy. The factors which affect pregnancy outcome and neonatal pathology are analyzed. The risks of potential complications of rheumatic diseases in these patients are evaluated. Special attention is given to the planning and preparing for pregnancy. Management of pregnancy in AFS and dosing regimen mainly depend on medical history, i.e., non-placental thrombosis, the number of spontaneous abortions, and prior therapy. Considering this, clinical groups with different therapy were described in the paper. It should be noted that some of the drugs under discussion are not approved by national regulatory authorities (Russian Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, Food and Drug Administration etc.) and are generally prescribed for an off-label use in real-world clinical practice.

Key words: antiphospholipid syndrome (AFS), pregnancy, prevention of exacerbations.

For citation: Trofimov E.A., Trofimova A.S. The course of antiphospholipid syndrome during pregnancy and its therapy // RMJ. 2016. № 15. P. 1032–1036.