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Preeclampsia and the Antiphospholipid Syndrome

Antiphospholipid syndrome (APS) is characterized by venous or arterial thrombosis and/or adverse pregnancy outcome in the presence of persistent laboratory evidence of antiphospholipid antibodies (aPLs). Preeclampsia complicates about 10–17% of pregnancies with APS. However, only early onset preecla...

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Autores principales: Mayer-Pickel, Karoline, Nanda, Manurishi, Gajic, Maja, Cervar-Zivkovic, Mila
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10452741/
https://www.ncbi.nlm.nih.gov/pubmed/37626793
http://dx.doi.org/10.3390/biomedicines11082298
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author Mayer-Pickel, Karoline
Nanda, Manurishi
Gajic, Maja
Cervar-Zivkovic, Mila
author_facet Mayer-Pickel, Karoline
Nanda, Manurishi
Gajic, Maja
Cervar-Zivkovic, Mila
author_sort Mayer-Pickel, Karoline
collection PubMed
description Antiphospholipid syndrome (APS) is characterized by venous or arterial thrombosis and/or adverse pregnancy outcome in the presence of persistent laboratory evidence of antiphospholipid antibodies (aPLs). Preeclampsia complicates about 10–17% of pregnancies with APS. However, only early onset preeclampsia (<34 weeks of gestation) belongs to the clinical criteria of APS. The similarities in the pathophysiology of early onset preeclampsia and APS emphasize an association of these two syndromes. Overall, both are the result of a defective trophoblast invasion and decidual transformation at early gestation. Women with APS are at increased risk for prematurity; the reasons are mostly iatrogenic due to placental dysfunction, such as preeclampsia or FGR. Interestingly, women with APS have also an increased risk for preterm delivery, even in the absence of FGR and preeclampsia, and therefore it is not indicated but spontaneous. The basic treatment of APS in pregnancy is low-dose aspirin and low-molecular-weight heparin. Nevertheless, up to 20–30% of women develop complications at early and late gestation, despite basic treatment. Several additional treatment options have been proposed, with hydroxychloroquine (HCQ) being one of the most efficient. Additionally, nutritional interventions, such as intake of vitamin D, have shown promising beneficial effects. Curcumin, due to its antioxidant and anti-inflammatory properties, might be considered as an additional intervention as well.
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spelling pubmed-104527412023-08-26 Preeclampsia and the Antiphospholipid Syndrome Mayer-Pickel, Karoline Nanda, Manurishi Gajic, Maja Cervar-Zivkovic, Mila Biomedicines Review Antiphospholipid syndrome (APS) is characterized by venous or arterial thrombosis and/or adverse pregnancy outcome in the presence of persistent laboratory evidence of antiphospholipid antibodies (aPLs). Preeclampsia complicates about 10–17% of pregnancies with APS. However, only early onset preeclampsia (<34 weeks of gestation) belongs to the clinical criteria of APS. The similarities in the pathophysiology of early onset preeclampsia and APS emphasize an association of these two syndromes. Overall, both are the result of a defective trophoblast invasion and decidual transformation at early gestation. Women with APS are at increased risk for prematurity; the reasons are mostly iatrogenic due to placental dysfunction, such as preeclampsia or FGR. Interestingly, women with APS have also an increased risk for preterm delivery, even in the absence of FGR and preeclampsia, and therefore it is not indicated but spontaneous. The basic treatment of APS in pregnancy is low-dose aspirin and low-molecular-weight heparin. Nevertheless, up to 20–30% of women develop complications at early and late gestation, despite basic treatment. Several additional treatment options have been proposed, with hydroxychloroquine (HCQ) being one of the most efficient. Additionally, nutritional interventions, such as intake of vitamin D, have shown promising beneficial effects. Curcumin, due to its antioxidant and anti-inflammatory properties, might be considered as an additional intervention as well. MDPI 2023-08-18 /pmc/articles/PMC10452741/ /pubmed/37626793 http://dx.doi.org/10.3390/biomedicines11082298 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Mayer-Pickel, Karoline
Nanda, Manurishi
Gajic, Maja
Cervar-Zivkovic, Mila
Preeclampsia and the Antiphospholipid Syndrome
title Preeclampsia and the Antiphospholipid Syndrome
title_full Preeclampsia and the Antiphospholipid Syndrome
title_fullStr Preeclampsia and the Antiphospholipid Syndrome
title_full_unstemmed Preeclampsia and the Antiphospholipid Syndrome
title_short Preeclampsia and the Antiphospholipid Syndrome
title_sort preeclampsia and the antiphospholipid syndrome
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10452741/
https://www.ncbi.nlm.nih.gov/pubmed/37626793
http://dx.doi.org/10.3390/biomedicines11082298
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