Heparin or aspirin or both in the treatment of recurrent abortions in women with antiphospholipid antibody (syndrome).

摘要: Purpose of review Presence antiphospholipid antibodies (aPL) is associated with unsuccessful pregnancy outcome. Based on an early concept aPL-induced thrombophilia and placental thrombosis, antithrombotic interventions have been used to reduce incidence miscarriage in antibody syndrome (APS). The aim this summarize current knowledge pathogenesis APS the impact different therapy strategies. Recent findings Pathogenetic concepts comprise aPL-mediated cell activation, disturbance coagulation along increased complement activation. There increasing evidence that heparin exerts its effect by inhibiting activation rather than anticoagulation capacity. In regard, outcome pregnancies has considerably improved invention therapies using combinations aspirin, unfractionated (UFH) and/or low molecular weight (LMWH). However, there no clear as which treatment regimen should be preferred. Some studies indicate superiority aspirin plus over aspirin-only. Whether heparin-only would confer equal effects whether UFH LMWH were comparable efficacy currently unknown. Summary Treatment decreases risk miscarriages APS. Well designed trials well better patients-at-risk profiling are warranted identify strategy favored detailed characterization aPL specificities could help individualizing therapy.