Antiphospholipid syndrome (APS) represents a serious risk factor in pregnancy resulting in several complications, leading to fetal loss and hemostatic complications. In this dedicated report, we describe our experiences in the treatment of pregnancies in patients with APS. The retrospective data from 140 pregnant women were investigated, and the treatment results of 121 patients were recorded. We studied two groups of patients receiving different treatment. The first group (n = 78) received the standard therapy with low-weight-molecular heparin (dalteparin 5000 U or certoparin 3000 U daily) and aspirin (100 mg daily) and in the second group (n 43) an additional 0.2 g/kg intravenous immunoglobulin (IVIG). Outcomes were 74.3% and 83.7% live births in the first group and in the second group, respectively. The abortion rate was similar in both groups (11.5% vs. 11.6%). The late complication rate was lower in the second group (5.8% vs. 14.1%, p < 0.05) than in the group with standard therapy. Interestingly, we found a trend to higher percentage (> 12%) of natural killer (NK) cells in patients with pregnancy complications (60% vs. 12%, p < 0.05). Our retrospective data shows an improvement of late pregnancy complications by additional use of IVIG. It is possible that IVIG influences higher NK cell activity in patients with previous pregnancy complications.
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Guys & St Thomas NHS Fdn Trust, Thrombosis & Haemostasis Ctr, London, EnglandGuys & St Thomas NHS Fdn Trust, Thrombosis & Haemostasis Ctr, London, England
Hunt, B. J.
Talavera-Garcia, E.
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Guys & St Thomas NHS Fdn Trust, Louise Coote Lupus Unit, London, EnglandGuys & St Thomas NHS Fdn Trust, Thrombosis & Haemostasis Ctr, London, England
Talavera-Garcia, E.
Lliso, G.
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Guys & St Thomas NHS Fdn Trust, Louise Coote Lupus Unit, London, EnglandGuys & St Thomas NHS Fdn Trust, Thrombosis & Haemostasis Ctr, London, England
Lliso, G.
Khamashta, M. A.
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Guys & St Thomas NHS Fdn Trust, Louise Coote Lupus Unit, London, EnglandGuys & St Thomas NHS Fdn Trust, Thrombosis & Haemostasis Ctr, London, England
Khamashta, M. A.
Cuadrado, M. J.
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Guys & St Thomas NHS Fdn Trust, Louise Coote Lupus Unit, London, EnglandGuys & St Thomas NHS Fdn Trust, Thrombosis & Haemostasis Ctr, London, England
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Univ Utah, Salt Lake City, UT USA
Intermt Healthcare, Salt Lake City, UT USASt Thomas Hosp, Thrombosis & Haemophilia Ctr, Westminster Bridge Rd, London SE1 7EH, England
Branch, D. Ware
Levy, Roger A.
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Univ Estado Rio de Janeiro, Discipline Rheumatol, BR-20550011 Rio De Janeiro, BrazilSt Thomas Hosp, Thrombosis & Haemophilia Ctr, Westminster Bridge Rd, London SE1 7EH, England
Levy, Roger A.
Middeldorp, Saskia
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Univ Amsterdam, Acad Med Ctr, Dept Vasc Med, Meibergdreef 9, NL-1105 AZ Amsterdam, NetherlandsSt Thomas Hosp, Thrombosis & Haemophilia Ctr, Westminster Bridge Rd, London SE1 7EH, England
Middeldorp, Saskia
Pavord, Sue
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Univ Hosp Leicester, Dept Haematol, Leicester, Leics, England
Oxford Univ Hosp, Dept Haematol, Oxford, EnglandSt Thomas Hosp, Thrombosis & Haemophilia Ctr, Westminster Bridge Rd, London SE1 7EH, England
Pavord, Sue
Roccatello, Dario
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Univ Turin, Struttura Complessa Direz Univ Immunol Clin, Ctr Ric Immunopatol & Documentaz Malattie Rare CM, Turin, Italy
Osped G Bosco, Turin, ItalySt Thomas Hosp, Thrombosis & Haemophilia Ctr, Westminster Bridge Rd, London SE1 7EH, England
Roccatello, Dario
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Ruiz-Irastorza, Guillermo
Tincani, Angela
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Univ Brescia, Dept Clin & Expt Sci, I-25121 Brescia, ItalySt Thomas Hosp, Thrombosis & Haemophilia Ctr, Westminster Bridge Rd, London SE1 7EH, England
Tincani, Angela
Khamashta, Munther
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Kings Coll London, Rayne Inst, St Thomas Hosp, Graham Hughes Lupus Res Lab,Div Womens Hlth, London WC2R 2LS, EnglandSt Thomas Hosp, Thrombosis & Haemophilia Ctr, Westminster Bridge Rd, London SE1 7EH, England
Khamashta, Munther
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Schreiber, Karen
Hunt, Beverley J.
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St Thomas Hosp, Thrombosis & Haemophilia Ctr, Westminster Bridge Rd, London SE1 7EH, EnglandSt Thomas Hosp, Thrombosis & Haemophilia Ctr, Westminster Bridge Rd, London SE1 7EH, England