The European Registry on Obstetric Antiphospholipid Syndrome (EUROAPS): A survey of 1000 consecutive cases
Por:
Alijotas-Reig, J, Esteve-Valverde, E, Ferrer-Oliveras, R, Lefkou, E, Belizna, C, Ruffatti, A, Tincani, A, Marozio, L, Espinosa, G, Rios-Garces, R, De Carolis, S, Latino, O, Llurba, E, Chighizola, CB, Rovere-Querini, P, Canti, V, Reshetnyak, T, Tabacco, S, Stojanovich, L, Gogou, V, Varoudis, A, Arnau, A, Ruiz-Hidalgo, D, Trape, J, Marti-Canamares, A, Bertero, MT, Kuzenko, A, Coloma, E, Meroni, PL, Ruano, A, del Ross, T, Melnychuk, T, Canti, V, Pengo, V, Gerosa, M, Fredi, M, Lundelin, K, Picardo, E, Cervera, R, Mekinian, A, Toth, B, Saez-Comet, L, Bremme, K, Mayer-Pickel, K, Gil-Aguado, A, Sos, L, Stoppani, C, Hoxha, A, Farran-Codina, I
Publicada:
1 abr 2019
Resumen:
Aim: To analyse the clinical features, laboratory data and foetal-maternal outcomes, and follow them up on a cohort of 1000 women with obstetric antiphospholipid syndrome (OAPS).
Methods: The European Registry of OAPS became a registry within the framework of the European Forum on Antiphospholipid Antibody projects and was placed on a website in June 2010. Thirty hospitals throughout Europe have collaborated to carry out this registry. Cases with obstetric complaints related to antiphospholipid antibodies (aPL) who tested positive for aPL at least twice were included prospectively and retrospectively. The seven-year survey results are reported.
Results: 1000 women with 3553 episodes were included of which 2553 were historical and 1000 were latest episodes. All cases fulfilled the Sydney classification criteria. According to the laboratory categories, 292 (29.2%) were in category I, 357 (35.7%) in Era, 224 (22.4%) in IIb and 127 (12.7%) in IIc. Miscarriages were the most prevalent clinical manifestation in 386 cases (38.6%). Moreover, the presence of early preeclampsia (PE) and early foetal growth restriction (FGR) appeared in 181 (18.1%) and 161 (16.1%), respectively. In this series, 448 (44.8%) women received the recommended OAPS treatment. Patients with recommended treatment had a good live-birth rate (85%), but worse results (72.4%) were obtained in patients with any treatment (low-dose aspirin (LDA) or low-molecular-weight heparin (LMWH) not on recommended schedule, while patients with no treatment showed a poor birth rate (49.6%).
Conclusion: In this series, recurrent miscarriage is the most frequent poor outcome. To avoid false-negative diagnoses, all laboratory category subsets were needed. OAPS cases have very good foetal-maternal outcomes when treated. Results suggest that we were able to improve our clinical practice to offer better treatment and outcomes to OAPS patients.
Filiaciones:
Alijotas-Reig, J:
Univ Autonoma Barcelona, Vall dHebron Univ Hosp, Dept Med, Syst Autoimmune Dis Unit,Dept Internal Med, Josep Ma de Segarra 2-F, Barcelona 08190, Catalonia, Spain
Esteve-Valverde, E:
Althaia Healthcare Network Manresa, Syst Autoimmune Dis Unit, Internal Med Dept, Barcelona, Spain
Ferrer-Oliveras, R:
Univ Autonoma Barcelona, Vall dHebron Univ Hosp, High Risk Unit, Obstet & Gynaecol Dept, Barcelona, Spain
Lefkou, E:
Hippokrat Hosp Thessaloniki, Haematol Unit, Thessaloniki, Greece
Belizna, C:
Univ Hosp Angers, Vasc & Coagulat Dept, Angers, France
Ruffatti, A:
Univ Padua, Azienda Osped, Dept Clin & Expt Med, Rheumatol Unit, Padua, Italy
Tincani, A:
Univ Brescia, Dept Clin & Expt Sci, Spedali Civili, Rheumatol & Clin Immunol Unit, Brescia, Italy
Marozio, L:
Univ Torino, Dept Obstet & Gynaecol, Turin, Italy
Espinosa, G:
Univ Barcelona, Hosp Clin, Syst Autoimmune Dis Serv, Barcelona, Spain
Rios-Garces, R:
Univ Barcelona, Hosp Clin, Syst Autoimmune Dis Serv, Barcelona, Spain
De Carolis, S:
Univ Cattolica Sacro Cuore, F Policlin Gemelli IRCCS, Dept Woman Child Hlth & Publ Hlth, Largo Francesco Vito 1, I-00168 Rome, Italy
Latino, O:
Dr Carlos G Durand Hosp, Autoimmune Thrombophil Dis & Pregnancy Div, Buenos Aires, DF, Argentina
Llurba, E:
Univ Hosp Santa Creu & St Pau, High Risk Unit, Obstet & Gynaecol Dept, Barcelona, Spain
Chighizola, CB:
Univ Milan, Dept Clin Sci & Community Hlth, Div Rheumatol, Milan, Italy
Rovere-Querini, P:
Univ Vita Salute San Raffaele, IRCCS Osped San Raffaele, Unit Med & Clin Immunol, Pregnancy & Rheumat Dis Clin, Milan, Italy
Canti, V:
Univ Vita Salute San Raffaele, IRCCS Osped San Raffaele, Unit Med & Clin Immunol, Pregnancy & Rheumat Dis Clin, Milan, Italy
Reshetnyak, T:
VA Nasonova Res Inst Rheumatol, Dept Syst Rheumat Dis, Moscow, Russia
Tabacco, S:
Sapienza Univ Rome, Dept Gynecol Obstet & Urol, Rome, Italy
Stojanovich, L:
Bezanijska Kosa Univ Med Ctr, Internal Med, Belgrade, Serbia
Gogou, V:
Hippokrat Hosp Thessaloniki, Haematol Unit, Thessaloniki, Greece
Varoudis, A:
Hippokrat Hosp Thessaloniki, Haematol Unit, Thessaloniki, Greece
Arnau, A:
Althaia Healthcare Univ Network Manresa, Clin Res Unit, Barcelona, Spain
Ruiz-Hidalgo, D:
Univ Autonoma Barcelona, Althaia Healthcare Network Manresa, Internal Med Dept, Barcelona, Spain
Trape, J:
Althaia Healthcare Univ Network Manresa, Dept Lab Med, Barcelona, Spain
Marti-Canamares, A:
Althaia Healthcare Univ Network Manresa, High Risk Unit, Obstetr & Gynaecol Dept, Barcelona, Spain
Canti, V:
Univ Vita Salute San Raffaele, IRCCS Osped San Raffaele, Unit Med & Clin Immunol, Pregnancy & Rheumat Dis Clin, Milan, Italy
Pengo, V:
Univ Padua, Dept Cardiac Thorac & Vasc Sci, Cardiol Unit, Padua, Italy
Gerosa, M:
Univ Milan, Dept Clin Sci & Community Hlth, Div Rheumatol, Milan, Italy
Lundelin, K:
Univ Turku, Fac Med, Dept Clin Sci, Dept Paedriat, Turku, Finland
Cervera, R:
Univ Barcelona, Hosp Clin, Syst Autoimmune Dis Serv, Barcelona, Spain
Mekinian, A:
UPMC Univ Paris 06, Sorbonne Univ, Serv Med Interne & Inflammat Immunpathol Biothera, Hop St Antoine,AP HP, F-75012 Paris, France
Saez-Comet, L:
Hosp Univ Miguel Servet, Dept Internal Med, Zaragoza, Spain
Mayer-Pickel, K:
Med Univ Graz, Dept Obstet, Graz, Austria
Sos, L:
Vilafranca Penedes Hosp, Androl & Male Reprod Unit, Urol Dept, Barcelona, Spain
Stoppani, C:
Althaia Healthcare Univ Network Manresa, High Risk Unit, Obstetr & Gynaecol Dept, Barcelona, Spain
Hoxha, A:
Univ Padua, Azienda Osped, Dept Clin & Expt Med, Rheumatol Unit, Padua, Italy
Farran-Codina, I:
Univ Autonoma Barcelona, Vall dHebron Univ Hosp, High Risk Unit, Obstet & Gynaecol Dept, Barcelona, Spain
Green Accepted
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