Comparison of the effectiveness of various methods of pregnancy loss prevention in women with antiphospholipid syndrome

Ekaterina  Orlova; Sergey  Chepanov; Ekaterina Kornyushina; Julian Ryzhov; Marina  Zainulina; Sergey  Selkov

doi:10.21638/spbu11.2019.430

Authors

Ekaterina Orlova D.O.Ott Research Institute of Obstetrics, Gynecology and Reproductology, 3, Mendeleevskaya lin., St. Petersburg, 199034, Russian Federation
Sergey Chepanov D.O.Ott Research Institute of Obstetrics, Gynecology and Reproductology, 3, Mendeleevskaya lin., St. Petersburg, 199034, Russian Federation
Ekaterina Kornyushina D.O.Ott Research Institute of Obstetrics, Gynecology and Reproductology, 3, Mendeleevskaya lin., St. Petersburg, 199034, Russian Federation
Julian Ryzhov D.O.Ott Research Institute of Obstetrics, Gynecology and Reproductology, 3, Mendeleevskaya lin., St. Petersburg, 199034, Russian Federation
Marina Zainulina V.F. Snegirev Maternity Hospital N 6, 5, ul. Mayakovskogo, St. Petersburg, 191014, Russian Federation
Sergey Selkov D.O.Ott Research Institute of Obstetrics, Gynecology and Reproductology, 3, Mendeleevskaya lin., St. Petersburg, 199034, Russian Federation

DOI:

https://doi.org/10.21638/spbu11.2019.430

Abstract

Around 10–15% women with recurrent pregnancy loss are diagnosed with antiphospholipid syndrome. In 20–30% women conventional therapy approaches do not lead to desirable outcomes. A possible approach to improve pregnancy outcomes in women with antiphospholipid syndrome is combined use of plasmapheresis and intravenous immunoglobulin in addition to a conventional therapy, which was assessed in this study in comparison with conventional therapy+plasmapheresis only; with conventional therapy+intravenous immunoglobulin only and with conventional therapy only. According to the results, combined use of plasmapheresis with immunomodulating intravenous immunoglobulin and conventional therpapy leads to the most significant antiphospholipid antibodies titer lowering, reduces prevalence of pregnancy complications, such as threatened abortion, mild preeclampsia, placental insufficiency, intrauterine growth restriction and increases prevalence of favourable pregnancy outcomes. It can be assumed that this approach can be considered as the most effective for the treatment of pregnant women with antiphospholipid syndrome for prevention gestational complications and pregnancy loss. antiphospholipid syndrome

Keywords:

antiphospholipid syndrome, antiphospholipid antibodies, recurrent pregnancy loss, intravenous immunoglobulins, plasmapheresis

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References

References

Chepanov S.V., Krivonos M.I., Arzhanova O.N., Shlyakhtenko T.N., Saidov N.Kh., Kornyushina E.A., Chudotvorov K.N., Sedikhin V.Yu., Selkov S.A. Characteristics of autoantibodies associated with recurrent Pregnancy loss. Akusherstvo i ginekologiia, 2019, no. 3, pp. 72–77. (In Russian)

Danza A., Ruiz-Irastorza G., Khamashta M. Antiphospohlipid syndrome in obstetrics. Best Practice & Research Clinical Obstetrics and Gynaecology, 2012, no. 26, pp. 65–76.

De Jesus G.R., Agmon-Levin N., Andrade C.A., Andreoli L., Chighizola C.B., Porter T.F., Salmon J., Silver R.M., Tincani A., Branch D.W. 14th International Congress on Antiphospholipid Antibodies Task Force Report on Obstetric Antiphospholipid Syndrome. Autoimmun. Rev.,2014, vol. 13, no. 8, pp.795–813.