| Autor: |
Wijeyaratne, C. N., Galappaththi, S. L. A., Palipane, E., Jayawardane, D. B. I. A., Dodampahala, S. H., Tudawe, M. N., Gooneratne, L. V., Silva, R. de, Ratnayake, D., Seneviratne, S. L. |
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| Zdroj: |
Obstetric Medicine (1753-495X); Jun2016, Vol. 9 Issue 2, p83-89, 7p, 4 Charts, 3 Graphs |
| Abstrakt: |
Problem Antiphospholipid syndrome is associated with recurrent pregnancy loss, and specific treatment improves pregnancy outcome. Laboratory diagnosis is limited in South Asia. We assessed management outcomes of definite/probable antiphospholipid syndrome treated at a tertiary centre in Sri Lanka. Method Descriptive cross-sectional study of pregnancy outcomes with heparin and aspirin therapy. Outcome measures: miscarriage, intrauterine death and live birth when compared to previous untreated pregnancies. Results Of 646 gestations in 145 women, 146 (22.6%) received specific treatment. In the preceding pregnancies without specific treatment, the rates of miscarriage, late fetal loss, stillbirth and live birth were 60%, 26%, 8% and 7%, respectively. Following specific treatment with low-dose aspirin ± low-molecular weight heparin in 146 pregnancies (145 women), the rates of miscarriage, late fetal loss, stillbirth and live birth were 14%, 10%, 3% and 74%, respectively. Mean birth weight was 2.54 ± 0.62 kg, preterm births complicated 32 (29.6%) with a mean gestational age at delivery 33.7 ± 2.6 weeks, with three neonatal deaths. Maternal complications were: pre-eclampsia 16 (10.9%), gestational diabetes 28 (19.2%), antepartum haemorrhage in 1 patient. Only 73/145 (50.3%) women had laboratory confirmation of antiphospholipid syndrome, while others were treated empirically. Live births in diagnosed vs. empiric treatment – 80.8% vs. 67.1%. Conclusion Pregnant women with clinical antiphospholipid syndrome when treated with low-dose aspirin and heparin, the live birth rate of 7% in the previous pregnancy resulted in live births of 74% in a resource limited South Asian setting. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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