Study to assess the prevalence of antiphospholipid syndrome (APS) among women with adverse pregnancy outcome in a tertiary care centre

Abstract

Introduction: Antiphospholipid syndrome is an autoimmune condition characterized by vascular thrombosis and/or pregnancy morbidity in the presence of antiphospholipid antibodies. A failure or significant delay in recognizing APS as the underlying disease entity may leave to the loss of an opportunity to prevent serious consequences of the disease particularly venous and arterial thrombotic events.

Aim of the Study: To find out the prevalence of antiphospholipid syndromeamong women with adverse pregnancy outcome in a tertiary care centre.

Methodology: Patients registered in O &G Department SAT Hospital, Medical College, Trivandrum, Kerala with adverse pregnancy outcomes meeting the inclusion and exclusion criteria were recruited for the study. They were followed up in the postnatal ward after abortion and preterm delivery as per protocol for bad obstetrics outcome evaluation. They were offered lab test in standard labs for APL Syndrome especially LAC and anti-cardiolipin antibodies IgM & IgG. Those tested positive were retested 12 weeks later also to confirm the test.

Results: In the present study, out of 216 cases of patients with adverse pregnancy outcome, 27 cases were found to be APLA positive giving a prevalence of 12.5%. In APLA positive cases LAC & ACLA were found to be positive in 11 cases each i. e 40.7% and in 5 cases both LAC & ACLA were positive i.e. 18.6%.

Conclusion: The important message is that even if a patient who is suspected clinically of APS does not fully satisfy the strict classification criteria, she may still have APS and require appropriate management including anticoagulation.