Síndrome de anticuerpos antifosfolípidos: asociación con abortos de repetición e infertilidad / Antiphospholipid syndrome: Association with abortions and infertility

ABSTRACT

The antiphospholipid syndrome is characterized by thromboembolic events and/or recurrent pregnancy loss in the presence of anticardiolipin antibodies and/or a lupus anticoagulant. Anticardiolipin antibodies are detected by ELISA whereas lupus anticoagulant detection includes a variety of coagulometric tests. Recurrent pregnancy loss associated with antiphospholipid antibodies is now considered a treatable clinical condition. Rather than being diagnostic tools only, antiphospholipid antibodies are thought to be pathogenic. The strongest demonstration of their pathogenic role lies in the ability to induce fetal resorptions when passively infused in pregnant naive animals. The management of pregnant patients with antiphospholipid syndrome is mainly based on the use of antiaggregant/anticoagulant agents (with acetylsalicylic acid and heparin) to prevent thrombosis in the uteroplacental circulation. Interventionswith these drug therapies and monitored pregnancy have increased fetal survival. However, this is still a matter of debate with no general agreement with respect to both pathophysiological significance of the presence of antiphospholipid antibodies and patient management (AU)