CHOICE OF ANTI-COAGULANT AND ITS EFFECT ON PREGNANCY OUTCOME IN PREGNANT WOMEN WITH ANTIPHOSPHOLIPID ANTIBODY SYNDROME

Abstract

Women with anti-phospholipid syndrome (APS) have a spontaneous abortion rate as high as 90% for pregnancies without pharmacologic treatment. APS is strongly correlated with recurrent abortion and pregnancy complications such as intrauterine growth restriction (IUGR), preterm labor, preeclampsia, and intrauterine fetal death (IUFD).The adverse effects of anti-phospholipid antibodies on trophoblast differentiation and invasion, placental infarctions, and thrombosis are thought to be responsible for recurrent abortion and pregnancy complications associated with APS. During the past 27 years, several treatments such as unfractionated heparin (UFH), low molecular weight heparin (LMWH), plasmapheresis, and moderate to high dose prednisone, intravenous immunoglobulin, and low dose aspirin (LDA) have been used in the management of pregnant women with history of recurrent pregnancy loss secondary to APS. A meta-analysis of 13 randomized or quasi- randomized controlled trials