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Antiphospholipid Antibodies and Recurrent Pregnancy Loss

Women with antiphospholipid antibodies have a significant risk of reproductive failure and adverse pregnancy outcomes. The incidence of recurrent abortion, fetal death, and intrauterine fetal growth retardation is significant. Women with a history of recurrent abortion and unexplained fetal death or a history of recurrent thrombotic episodes should be screened for the presence of antiphospholipid antibodies. The benefit of routine screening of pregnant women for the presence of these antibodies has not been established, and the yield from such screening studies has been found to be low. No treatment regimen has eliminated fetal loss and adverse pregnancy events completely in women with the antiphospholipid antibody syndrome. Even when treatment is instituted, maternal and fetal status must be monitored closely. Management of such patients has not been standardized, and various treatment regimens have been found to be efficacious. Multicenter randomized treatment trials are currently underway, and standardization of therapy in these patients may be achieved.