How Antiphospholipid Antibody Syndrome Affects Pregnancy

 

The Antiphospholipid Syndrome Dr. Michael Linenberger

Video taken from the channel: UW Video


 

Dr Hannah Cohen How To Manage APS In Pregnancy HSF Patients’ Day May 13 2015 2

Video taken from the channel: APS Support UK


 

The Antiphospholipid Syndrome: TMAs & pregnancy Dr Karen Breen

Video taken from the channel: Thrombosis UK


 

Antiphospholipid Antibody Syndrome: A Patient’s Journey

Video taken from the channel: American Society of Hematology


 

Antiphospholipid syndrome: clinical features, diagnosis and management

Video taken from the channel: Internal Medicine


 

Antiphospholipid Antibody Syndrome

Video taken from the channel: Learning in 10


 

Antiphospholipid syndrome causes, symptoms, diagnosis, treatment, pathology

Video taken from the channel: Osmosis


Key points about antiphospholipid syndrome in pregnancy Antiphospholipid syndrome is an autoimmune disease. It can cause life-threatening blood clots. If you have this condition in pregnancy, your healthcare provider will watch you closely.

Antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by venous or arterial thrombosis and/or pregnancy loss in the presence of persistent antiphospholipid antibodies (aPL). It can occur as a primary condition, or it can occur with systemic lupus erythematosus (SLE) or another systemic autoimmune disease. Normally antibodies, chemicals made by the immune system, are helpful in fighting germs or viral infections from outside the body. However in APS, the immune system makes antibodies that cause blood to clot abnormally.

This may cause problems with the pregnancy. H. Yamada, T. Atsumi, G. Kobashi, et al.Antiphospholipid antibodies increase the risk of pregnancy-induced hypertension and adverse pregnancy outcomes J. Antiphospholipid syndrome (APS) is an autoimmune disorder that is associated with pregnancy complications, including preeclampsia, thrombosis, autoimmune thrombocytopenia, fetal growth restrictio.

The aPL in the cohort decreased marginally during pregnancy, and changes were not associated with pregnancy outcomes. Our results suggest that, among women with aPL and/or SLE, measuring aPL early in pregnancy is sufficient to assess risk. LAC frequency also decreased, but 75% of patients remained positivethrough the second trimester. Only 4% of patients with aPL at baseline did nothave aPL in either the second or third trimesters.

Changes in aPL levels or aPLstatus were not associated with adverse pregnancy outcomes. in En, Portuguese. Antiphospholipid antibody syndrome (APS) is a systemic, autoimmune, prothrombotic disease characterized by persistent antiphospholipid antibodies (aPLs), thrombosis, recurrent abortion, complications during pregnancy, and occasionally thrombocytopenia. Antiphospholipid antibody syndrome is an autoimmune disorder in which the body’s immune system makes antibodies that attack phospholipids, causing cell damage and blood clots.

Learn more about causes, risk factors, signs and symptoms, complications, diagnoses, treatments, and. Antiphospholipid syndrome (APS), also known as Hughes Syndrome, is a systemic autoimmune disease characterized by thrombosis and/or pregnancy morbidity in the presence of persistently positive antiphospholipid antibodies 1. When APS was first described, it was in the presence of systemic lupus erythematosus (SLE).

List of related literature:

Antiphospholipid antibody and active SLE may affect the fetus” through placental abnormalities”, as indicated above.

“Clinical Maternal-Fetal Medicine” by Hung N. Winn, John C. Hobbins
from Clinical Maternal-Fetal Medicine
by Hung N. Winn, John C. Hobbins
Taylor & Francis, 2000

During a subsequent pregnancy with an RhDpositive fetus, these antibodies can cross the placenta and cause haemolytic disease of the newborn and severe neurological damage.

“Davidson's Essentials of Medicine E-Book” by J. Alastair Innes
from Davidson’s Essentials of Medicine E-Book
by J. Alastair Innes
Elsevier Health Sciences, 2020

Antiphospholipid antibody syndrome will not affect all of her pregnancies d.

“Core Curriculum for Maternal-Newborn Nursing E-Book” by AWHONN, Susan Mattson, Judy E. Smith
from Core Curriculum for Maternal-Newborn Nursing E-Book
by AWHONN, Susan Mattson, Judy E. Smith
Elsevier Health Sciences, 2010

Intravenous immunoglobulin treatment of pregnant patients with recurrent pregnancy losses associated with antiphospholipid antibodies.

“Consultative Hemostasis and Thrombosis E-Book” by Craig S. Kitchens, Barbara A Konkle, Craig M. Kessler
from Consultative Hemostasis and Thrombosis E-Book
by Craig S. Kitchens, Barbara A Konkle, Craig M. Kessler
Elsevier Health Sciences, 2018

Pregnancy failure in patients with obstetric antiphospholipid syndrome with conventional treatment: the influence of a triple positive antibody profile.

“Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice E-Book” by Robert Resnik, Charles J. Lockwood, Thomas Moore, Michael F Greene, Joshua Copel, Robert M Silver
from Creasy and Resnik’s Maternal-Fetal Medicine: Principles and Practice E-Book
by Robert Resnik, Charles J. Lockwood, et. al.
Elsevier Health Sciences, 2018

Increased antiphospholipid antibody levels have been found in pregnant women with lupus who have Glycoprotein had miscarriages.

“Davis's Comprehensive Manual of Laboratory and Diagnostic Tests with Nursing Implications” by Anne M Van Leeuwen, Mickey L Bladh
from Davis’s Comprehensive Manual of Laboratory and Diagnostic Tests with Nursing Implications
by Anne M Van Leeuwen, Mickey L Bladh
F.A. Davis Company, 2019

The risk for current pregnancy loss due to antiphospholipid antibody is a function both of prior maternal pregnancy history and of titer of anticardiolipin antibody and/or lupus anticoagulant.

“Systemic Lupus Erythematosus” by Robert G. Lahita
from Systemic Lupus Erythematosus
by Robert G. Lahita
Elsevier Science, 2004

It is usually weak, consisting predominantly of immunoglobulin M (IgM) that does not cross the placenta.

“High Risk Pregnancy E-Book: Management Options Expert Consult” by David K. James, Philip J. Steer, Carl P. Weiner, Bernard Gonik
from High Risk Pregnancy E-Book: Management Options Expert Consult
by David K. James, Philip J. Steer, et. al.
Elsevier Health Sciences, 2010

When we studied lungs from a patient dying shortly after pregnancy, numerous apparent syncytiotrophoblastic cells were present in pulmonary capillaries, but staining with anti–human chorionic gonadotropin (hCG) antibodies failed because the cells had already lost their cytoplasm.

“Pathology of the Human Placenta, 5th Edition” by Kurt Benirschke, Peter Kaufmann, Rebecca N Baergen
from Pathology of the Human Placenta, 5th Edition
by Kurt Benirschke, Peter Kaufmann, Rebecca N Baergen
Springer New York, 2006

Fetal Complications If antiphospholipid antibodies, anti-Ro and anti-La antibodies, maternal fever, severe anemia, uremia, hypertension, and preeclampsia are absent, active SLE itself does not compromise the fetus.

“Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice E-Book” by Robert Resnik, Robert K. Creasy, Jay D. Iams, Charles J. Lockwood, Thomas Moore, Michael F Greene, Lesley Frazier
from Creasy and Resnik’s Maternal-Fetal Medicine: Principles and Practice E-Book
by Robert Resnik, Robert K. Creasy, et. al.
Elsevier Health Sciences, 2008

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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46 comments

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  • It also takes at least one doctor after 10 years of telling them, MY LEGS HURT! and they did everything including telling me I needed a psychiatrist. I went to the U of Chicago and Mayo. Had I not gone into AFIB for about 8 hrs they never would have done the CT that presented 2 large Pulmonary Embolisms and two legs with multiple clots. A rheumatologist finally put it together back locally. The problem for a man with this disease is unless and have a couple of miscarriages or a stroke,It would not have been found. I was very lucky.(in a not dying kinda way)

  • According to Robbins and cotran basics of pathology
    Fetal loss does not appear to stem from thrombosis, but rather seems from anybody mediated interference with growth and differentiation of trophoblast, leasing to a failure of placentation. (Pg 124 )

  • Hello mam I faced two miscarriage due to anti bodies. My anti beta2 gp 1 anti body screening is 39.34 U/ml(Positive). What to do please suggest

  • I was diagnosed with APS following a TIA. While only on high doses of aspirin and Atorvastatin, I had a heart attack just 5 years later. Now, I take Xarelto, since I had gastric bleeding with Coumadin.

  • Are you guys sure its predominantly males who get it? According to Wikipedia its predominately females.

    Just want my test questions right!

  • I hope more doctors and med students watch this video. I remember going to my primary care doctor after being diagnosed with this and telling him I had this. and he legit had to pull his phone out and look it up on web md. it is just a not very well known condition

  • I was 15 when I was diagnosed with APS. 16 years ago, I was not pregnant or anything it just happened. 7 masses in my brain = clots. They’re still there after recent MRI’s.

  • Is it possible for women with APS delivered her baby normally?

    My ACA and LA are positive..
    APTT and DDimer are ups and downs, so I have to control what I eat a day..

    I prescribed with aspirin, but not with heparin..
    I also prescribed with omega 3..

    This is my third pregnancy.. The two pregnancy before I had C section..

    Is it possible for me to have a normal birth now?

  • Nice Video! Excuse me for chiming in, I would appreciate your thoughts. Have you researched Ganrayden Peerless Gratification (probably on Google)? It is a great one off guide for eradicating your urticaria without the headache. Ive heard some extraordinary things about it and my m8 after many years got excellent success with it.

  • U guys are doing a phenomenal job…!! These videos are gonna help alot of upcoming doctors..!! Thank u so much….! &All the best…!!

  • spellbound! very nice. I think you can add about other treatment modalities such as eculizumab in refractory case/ aPL nephropathy, immunomodulator in autoimmune hemolytic anaemia/ thrombocytopenia.

  • Im so scared ive been two miscarriages then i am pregnant now. My last baby has iugr. Unfortunately shes doesnt make bacause she diagnosed dat she has a isophageal atresia she is not well develope on my womb. Now im so scared. After i heared ds.

  • Though a percentage of patients with antiphospholipid autoimmune disorder have a tendency to form clots, it is error to define antiphospholipid autoimmune syndrome as a blood clotting disorder, as current research finds that percentage of patients with antiphospholipid autoimmune syndrome do not have the tendency to form clots and anticoagulants for such patients is contraindicated, if not dangerous.. In fact, APLAS has subsets. Some patients with APLAS have thrombocytopenia (a tendency to hemorrhage), some have both thrombophilia and thrombocytopenia, some have neither but have a history of fetal loss and premature births. Please See: “Nonthrombotic manifestations of the antiphospholipid syndrome: away from thrombosis?,” Asherson, et al.

  • 4 years ago at age 61 i had a pe, then 1 year later a sagital sinus and straight sinus thrombosis, and shortly after was diagnosed with sjogrens, then 3 years later while being therapeutic on warfin had a blood clot on my spleen. then the tests came lots of them, where i was diagnosed with antiphosholipid tyndrome. i never had any miscarriages. delivered 4 health children. it has been thought that i had aquired sjogrens. any comments?

  • Another great rundown! �� It’s worth noting the laboratory studies �� inclusive of diagnosis are not routinely run. Also, the aggressive immunosuppressive therapy is usually not indicated unless all other modalities are exhausted. Thanks for pointing this out! ☝️��

  • WOW, UNREAL!!! I THOUGHT I HAD IT BAD!! BUT TO KNOW THAT CANNABIS CAN REVERSE THESE SYMPTOMS IS UNREAL!!! WHY EVERY STATE IS NOT LEGALIZING THIS SUBSTANCE IS INSANE!!

  • My husband died of this two years ago. I believe he receive good care our local hospital. But he had the catastrophic type. He was really doomed from the onset. For him, the symptoms started with a strange metallic taste in his mouth. Within 5 months he was gone. He lost 83 pounds and went through a tremendous amount of pain. There isn’t a cure for everything. His family wanted to blame the doctors, the hospital and me. But sometimes we just get sick and die. He had a great faith in God and I believe he’s in heaven today.

  • Hai!why abs get belly after a liver stenting due to primary APLA syndrome. Is that may cause of clexane injection in center abs? Pls reply soon

  • My wife suffers from aps, it was missdiagnosed for 7 years, and it has almost killed her twice (venus vien thrombosis and a deep vien thrombosis).
    We never knew she had aps till 3 years after our son was born. We never knew how lucky we were till we did more research into aps.

    To all those people suffering, you are not alone.

  • 35yr old male here, had a PE in December ’18 and my hematologist diagnosed me with APS. It’s being recommended I stay on my blood thinner (Eliquis) for life.

  • I’m a male and have it and it caused my heart attack due to a clot in the major artery when I was 18, I’m 19 and almost normal now!

  • Will not a Plasmapheresis before delivery reduce the risk of a thrombotic event(Stroke) during a medication-free delivery for such a patient?

  • My daughter is 21 yrs old has lupus has had heart attack gets horrible rashes and boils, FEELS like she is going to have a seizure, migraines or is so sad she suffers so much everyday�� I wish she had a Dr like him����

  • I loss my baby due to thick placenta and less. Blood supply.My APS was. negative before pregancy. I took aspirin. And heparin. But still. Loos my baby. Soon. After my miscrriage I was found to. Be postive for antibeta2glyco protein igm means it’s new.. Doctor diagnosed it as obestric APLA. Rite now I. Am. On. Wysolone hydroxycholoquine and tacrolimus. Is it enough. What ate my chance of having a live baby. I am. So tensed

  • I have had DVT since 3 years ago (and now it looks slowly disappear) and my syphilis test always came back false positive when I tried to donate my blood, how can I convince my doctor to get me tested on APL antibodies?
    I read that false positive syphlis is a sign various disease, two of them are SLE and APS. I thought I had SLE since all my symptoms match but I had negative ANA and dsDNA and my rheumatologist seems not interested in my history with DVT and syphilis test false positive result.
    I don’t have enough money to test on my own and I’m waiting doctor to put me on test so my bill got covered by gov health care.

  • @Aida, ask for the blood test, ask to see a hematologist. Be aggressive with your health and ask questions and get answers from the doctors. You have to be your own activist for your health. Good luck, I have had this for 12 years, in and out of the hospital. I know how you feel, stay strong and do not give up! ����

  • Thanks for your videos! Always knew something new from them though I had graduated 9 years ago. But could you please add some photos of skin lesions to your videos? It is hard to recognise any only by description. With real pictures your videos could be way more informative and useful.

  • I’m 19 years old and have survived 2 PE’s as well.. both undiagnosed as to what they were caused from. My hematologists were convinced it must have been APS, but those blood tests came back negative. More awareness needs to be made about these ‘silent killers’ however. Too many have been taken so suddenly.

  • As someone with APS and SLE it is scary to think of what could have happened. I had PEs on two occasions (once in my last pregnancy which I didn’t know about and was lucky to survive)!

    It is time awareness is heightened on these serious condition.

  • my mother had 3 major strokes in 2004 she pulled through and is now a grandmother to my 15 month old son and our next baby is due in july of this year. she is an amazing woman as are all those that survive this disease. and now they are saying it is hereditary. myself my brother and my son have been tested for the disease and we are waiting on the results

  • wow its a nice lecture. thank you so much for sharing. i am lil confused in the table you showed at 48:50, doesnt the treatment all showed that leads to take oral aspirin and the LMWH? when to use what drug i couldnt understand. can you please help me read that table clearly? thankyou.

  • Thank you so much, this is an excellent video, but to know about the precautions click on the link: https://hi.medtime.in/एंटीफॉस्फोलिपिड/सिंड्रोम-के-लक्षण/

  • I have factor XIII deficiency,and also have a desease ‘easy bruises & internal bleeding,my INR and PT rate is also very high,due to use anticoaglant, Rivaroxaban in the past for the led desease,I have no blood clot, please tell me that what I could do.

  • I have been loking for the link between antiphospholid syndrome and the hypercoagulable state and misacrriage for a while but ididnt find explanations now everything is clear thank you very much

  • Hey I had a question, what’s the difference between polyp and papilla? Is it just about the mucous membranes or is anything else involved? If you could please clarify this. Thanks

  • I had two miscarriages,it was 7 years ago. I was feeling scared to have a baby again, but then I tried to knew what had happened to the two baby and I found out that I have Aps.Anti Phospholipid syndrome. It made me feel bad about the past but it cleared my mind and I have a chance to have a baby again by monitoring and medicine.��

  • it took 6 miscarriages,1 stillbirth before i was diagnosed with APAS.until i went into a not so accepted treatment back in 2004,i had a baby girl at last.May God bless all these doctors for their perserverance.

  • I was 25 years old, I started feeling sick, went to the emergency room, and the next thing I know I’m waking up 2 weeks later. Turns out I have catastrophic antiphospholidid antibody syndrome. I have had multiple heart attacks and multiple strokes because of it. It has been a crazy road.

  • Thank you so much. I am diagnosed catastrophic antiphosphilipid antibody syndrome..please if you can translate this video to arabic

  • Thank you so much..for very important information..now im thinking that woman like me who have APA’s can able to have alive baby..thank you����

  • M/15 years old, just been diagnosed with this. Im on 2 heparin injections daily, later on ill be on other bloodthinner pills. Im on Clexane for now due to me having a mini thrombosis in the toes.

  • I have 2 recurrent missed miscarriage within 2yr,due to blood clotting,but there was no bleeding no pain and no more symptoms, fetal heartbeat has gone at 8week USG..i took progesterone & folate.but nothing was done with that..my ESR 80, & wbc count 12000 during pregnancy..plss suggest me..

  • tbank you for all these studies,,after 7miscarriages,i battled APAS.with combination of LIT,progesterone,heparin,aspirin. These doctors are God sent.

  • I have the disorder and had a premature birth by c-section…it almost killed me because I was undiagnosed. I needed 7 blood transfusions (because when they cut me open I was bleeding to death) and became anemic for 2 yrs. after my daughter’s birth. My daughter was also anemic. I also went into HELLP Syndrome prior to the birth…..I shouldn’t be here but I’m fine!!!!!!!

  • Why are pulmonary embolisms so dangerous? People don’t even need both lungs to live so why is it so bad that blood flow stops in some section of one of the lungs?

  • Where can I get tested? my medical provider is not giving me any answers and my symptoms continue to worsen after 3 strokes and several TIAs…