Autoimmune disease in pregnancy - Antiphospholipid syndrome (APS)

Antiphospholipid syndrome (APS), Hughes syndrome and pregnancy.

Antiphospholipid syndrome and pregnancy

Antiphospholipid syndrome is an autoimmune disorder that is associated with pregnancy complications. However most people with APS only get one of these complications not all of them. They include: recurrent miscarriage, early delivery, tiny blood clots in the blood vessels within the placenta, growth restriction of the foetus, stillbirth, and pre-eclampsia. 

Planning your pregnancy
Women with diagnosed APS are advised to plan for pregnancy because treatment to improve the outcome is more successful when it begins as soon as possible after conceiving. Also because some medications used to treat APS could also harm an unborn baby and these are stopped when planning to become pregnant.

Treatment during pregnancy
This involves taking daily doses of aspirin or heparin, or a combination of both. The doctors decide this considering the history of blood clots and complications during any previous pregnancy.  
These treatments usually start at the beginning of the pregnancy and may continue for one to six weeks after birth.
But don’t despair. These pregnancies are treatable. In our recent study (the largest and most detailed one done to date), pregnancy outcome was about the same as for women with diabetes, kidney disease, or poor socioeconomic conditions. More than 9 of 10 pregnancies survived, and about 8 of 10 pregnancies went to full term. Of course patients were very closely monitored and treated, mostly with a form of injectable heparin (a blood thinner). The common problems were prematurity and high blood pressure (a pregnancy complication seen in many circumstances); the problems occurred most often in patients who also had lupus. Dr Michael Lockshin.
Working closely with an obstetricians and/or gynecologists during pregnancy is advised as they have the means to prevent thrombosis and the other pregnancy complications associated with APS.

Support for those with APS:
APS Support UK has a pregnancy support forum.

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