Obstetrical antiphospholipid syndrome

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Since the 1950s it has been known that the presence of a high concentration of antiphospholipid antibodies (APAs) can cause numerous obsteteric complications such as miscarriage, intrauterine growth retardation and pre-eclampsia (Sarig et al 2002).

APAs are a type of antibody - 'proteins that are made by the immune system as a primary defense against infection or injury by foreign proteins. (The immune system is able to distinguish between proteins that are "self" and those which are foreign, or "nonself".)' (Sher et al 2005).

The APAs are said to attack the placental cells and blood supply. Treatment with low-dose aspirin and heparin has been shown to significantly reduce the risk of miscarriage. In fact, studies have shown that with no treatment, the live-birth rate can be as low as 10%, with heparin only 40% and with the combined aspirin and heparin a remarkable 70% (Rai et al 1997). More recent studies have looked at the management guide of antiphospholipid syndrome as combining aspirin, heparin and intravenous immunoglobulin (Asherton et al 2006, Erkan & Lockshin 2006).

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