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Plasmapheresis and pregnancy outcome in patients with antiphospholipid syndrome.

AbstractOBJECTIVE:
To assess plasmapheresis with low dose prednisone on obstetric and neonatal outcomes among unsuccessfully treated pregnant women with documented antiphospholipid syndrome (APS).
METHODS:
Eighteen pregnant women received prednisone (10 mg/day) and plasmapheresis at 7.08+/-0.6 weeks of gestation, for 3 sessions per week, until lupus anticoagulant activity suppressed and IgG anticardiolipin lowered. Serial pulsatility indexes (PI) of umbilical and uterine arteries were performed.
RESULTS:
The live birth rate was 100%; mild pre-eclampsia 5.5%; preterm deliveries 22.22%; intrauterine growth restriction 11.11%; thrombocytopenia 5.5%; oligohydramnios and fetal distress 16.6%. There were no perinatal deaths, thrombotic events or lupus flare. Uterine artery PI was reduced and umbilical artery PI was >95th percentile.
CONCLUSION:
Plasmapheresis and low dose prednisone were associated with a low rate of obstetric and neonatal complications. Plasmapheresis may be used to treat pregnant women with documented APS when first lines (aspirin and/or heparin) fail to prevent pregnancy loss.
AuthorsD O El-Haieg, M F Zanati, F M El-Foual
JournalInternational journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics (Int J Gynaecol Obstet) Vol. 99 Issue 3 Pg. 236-41 (Dec 2007) ISSN: 0020-7292 [Print] United States
PMID17897649 (Publication Type: Clinical Trial, Journal Article)
Chemical References
  • Anti-Inflammatory Agents
  • Prednisone
Topics
  • Abortion, Habitual (therapy)
  • Adult
  • Anti-Inflammatory Agents (therapeutic use)
  • Antiphospholipid Syndrome (therapy)
  • Female
  • Humans
  • Live Birth
  • Pilot Projects
  • Plasmapheresis
  • Prednisone (therapeutic use)
  • Pregnancy
  • Pregnancy Complications, Hematologic (therapy)
  • Pulsatile Flow

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