Diagnosis and management of antiphospholipid syndrome in pregnancy

Key content: The diagnosis of antiphospholipid syndrome (APS) requires both characteristic clinical features and persistently abnormal laboratory tests. Antiphospholipid syndrome can cause serious morbidity in mother and fetus. Good management in an expert setting can result in a live birth rate of > 80%. Prepregnancy assessment and counselling play an important part in optimising the chances of a subsequent successful pregnancy. Learning objectives: To understand the clinical features and pathophysiology of APS. To learn the principles of management of APS in pregnancy. To learn about the key points of prepregnancy assessment and counselling. Ethical issues: Prepregnancy assessment and counselling provide realistic guidance to women, enabling them to make informed decisions regarding future pregnancies. Some women with APS are at very high risk of thrombotic events during pregnancy and expert opinion needs to be sought to give a clear plan for thromboprophylaxis for these cases.