Diagnóstico laboratorial da síndrome antifosfolípide obstétrica: uma revisão integrativa.

Abstract

Antiphospholipid syndrome (APS), or Hughes's disease, is the most common acquired thrombophilia in young adults, is an autoimmune systemic disease. Occurs primarily or in association with diseases of the conjunctiva, particularly lupus erythematosus. In obstetrics, this syndrome is characterized clinically by the occurrence of abnormalities in pregnancy, and may be associated with recurrent venous, arterial or microcirculatory thrombosis. The objective of this study was to identify the specific laboratory predictors of high risk for fetal loss, as well as the main associated symptomatologies. Regarding the treatment, the most used treatment and the efficacy of pharmacotherapy were evidenced. Through analysis of studies between 2005 and 2018, 1557 pregnant patients diagnosed with classic antiphospholipid syndrome with a mean age of 31 years were selected from articles analyzed. The condition most associated with patients with obstetric SAF in the present study was the presence of previous abortion, followed by early parturition, thrombosis, fetal death, recurrent abortion and pre-eclampsia. The laboratory predictors associated with obstetric antiphospholipid syndrome were lupus anticoagulant and anticardiolipin IgG / IgM, and the most common association was anticardiolipin IgM with AL, the most commonly used treatment was low molecular weight heparin associated with aspirin. The use of pharmacotherapy increased by four times the rate of birth. Therefore, it is necessary to carry out a study to complement the profile of the patients of this syndrome in pregnancy, since the development of antiphospholipid antibodies appears to be frequent in critically ill patients, but more studies are needed to clarify their pathogenic role and implications in clinical practice.