Obstetrical antiphospholipid antibody syndrome in a case series in Cuba

Abstract

Introduction: antiphospholipid antibody syndrome (APS) is an acquired prothrombotic state characterized by the presence of antiphospholipid antibodies in patients with venous or arterial thrombosis and increased morbidity during pregnancy.
Objectives: describe the main clinical and epidemiological features of the syndrome during pregnancy as well as its perinatal outcomes.
Methods: a descriptive analytical study was conducted of a series of patients with antiphospholipid antibody syndrome and pregnancy at the Center for Medical Surgical Research and the National Rheumatology Center in Havana, Cuba. The study series was composed of 188 women. Examination was performed of the medical records of pregnant women either hospitalized or attending outpatient consultation at the two institutions who had been diagnosed with the syndrome as a primary or a secondary condition. A database was developed with epidemiological variables such as characteristics of the pregnancy and maternal fetal outcome.
Results: of the total patients studied in the series, 32 had thrombosis with obstetric morbidity. Primary antiphospholipid antibody syndrome was diagnosed in six patients, whereas secondary APS was diagnosed in 26 (17.5%). Mean age was 27 years. With respect to skin color, six out of every ten patients were white, and the rest were either brown or black. There were 81 pregnancies in the series, i.e. 2.53 patients / pregnancy, with 76% live births, 18% spontaneous abortions and 5% fetal deaths. 16% had a preterm delivery and 10% developed preeclampsia. There were no maternal deaths.
Conclusions: pregnancy in patients with antiphospholipid antibody syndrome is highly risky, with increased maternal and fetal morbidity and mortality.