Use of plasmapheresis in treatment of patients with unfavorable anamnestic pregnancy outcomes coupled to antiphospholipid antibodies
Aim: to evaluate efficacy of plasmapheresis combined with low molecular weight heparins (LMWH) and acetylsalicylic acid (ASA).Materials and Methods. 327 plasmapheresis sessions were performed for 75 patients: 17 (22.6 %) patients during preparation for pregnancy, 11 (19.0 %) pregnant women in the fi...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | Russian |
| Published: |
IRBIS LLC
2021-03-01
|
| Series: | Акушерство, гинекология и репродукция |
| Subjects: | |
| Online Access: | https://www.gynecology.su/jour/article/view/931 |
| _version_ | 1797884035080388608 |
|---|---|
| author | D. R. Eremeeva M. S. Zainulina Yu. S. Dolgova R. A. Shakhaliev O. A. Silvanovich L. A. Pavlova |
| author_facet | D. R. Eremeeva M. S. Zainulina Yu. S. Dolgova R. A. Shakhaliev O. A. Silvanovich L. A. Pavlova |
| author_sort | D. R. Eremeeva |
| collection | DOAJ |
| description | Aim: to evaluate efficacy of plasmapheresis combined with low molecular weight heparins (LMWH) and acetylsalicylic acid (ASA).Materials and Methods. 327 plasmapheresis sessions were performed for 75 patients: 17 (22.6 %) patients during preparation for pregnancy, 11 (19.0 %) pregnant women in the first trimester, 33 (56.9 %) pregnant women in the second trimester, and 34 (58.6 %) pregnant women in the third trimester. Study inclusion criteria were as follows: high titers of antiphospholipid antibodies (APA) as well as included non-inclusion criteria in pregnant women with miscarriages and unfavorable anamnestic pregnancy outcome. 36 (62.1 %) women had pregnancy loss in anamnesis. All patients received low-dose ASA and LMWH therapy; 15 (25.86 %) pregnant women also received courses of intravenous immunoglobulins in the first and second trimesters.Results. 47 pregnant women had delivery, whereas 10 of women had pregnancy in progress. Term delivery was in 40 (85.1 %) patients, so that 23 (48.9 %) pregnant women had delivery per vias naturales. The average weight of the fetus was 3364.00 ± 393.76 g, height - 52.13 ± 1.82 cm. In 100 % cases, Apgar score was 8 points. 24 (51.1%) pregnant women had delivery via cesarean section. The average blood loss comprised 528.64 ± 166.10 ml. The average fetal weight in group after surgical delivery was 2982.14 ± 582.88 g, average height - 49.14 ± 4.09 cm, the Apgar score - 7.69 ± 0.47 points. Preterm births were observed in 7 (14.9%) cases, all via cesarean section. In 1 case, early fetal death was at gestational age of 8/9 weeks; according to the karyotyping data, a fetal chromosomal abnormality was detected. No severe obstetric complications were observed.Conclusions. Combining plasmapheresis with low dose LMWH and ASA therapy demonstrated high efficacy in treating obstetric APS manifested as high percentage of favorable pregnancy outcomes and low number of obstetric complications. |
| first_indexed | 2024-04-10T04:01:14Z |
| format | Article |
| id | doaj.art-0f3fa3965aa74792b799cb5c4c61ca55 |
| institution | Directory Open Access Journal |
| issn | 2313-7347 2500-3194 |
| language | Russian |
| last_indexed | 2024-04-10T04:01:14Z |
| publishDate | 2021-03-01 |
| publisher | IRBIS LLC |
| record_format | Article |
| series | Акушерство, гинекология и репродукция |
| spelling | doaj.art-0f3fa3965aa74792b799cb5c4c61ca552023-03-13T07:09:51ZrusIRBIS LLCАкушерство, гинекология и репродукция2313-73472500-31942021-03-01151223110.17749/2313-7347/ob.gyn.rep.2021.105627Use of plasmapheresis in treatment of patients with unfavorable anamnestic pregnancy outcomes coupled to antiphospholipid antibodiesD. R. Eremeeva0M. S. Zainulina1Yu. S. Dolgova2R. A. Shakhaliev3O. A. Silvanovich4L. A. Pavlova5Pavlov First Saint Petersburg State Medical University, Health Ministry of Russian Federation; Snegirev Maternity Hospital № 6Pavlov First Saint Petersburg State Medical University, Health Ministry of Russian Federation; Snegirev Maternity Hospital № 6Pavlov First Saint Petersburg State Medical University, Health Ministry of Russian Federation; Snegirev Maternity Hospital № 6Pavlov First Saint Petersburg State Medical University, Health Ministry of Russian FederationSaint Petersburg State Pediatric Medical University, Health Ministry of Russian FederationSaint Petersburg State Pediatric Medical University, Health Ministry of Russian FederationAim: to evaluate efficacy of plasmapheresis combined with low molecular weight heparins (LMWH) and acetylsalicylic acid (ASA).Materials and Methods. 327 plasmapheresis sessions were performed for 75 patients: 17 (22.6 %) patients during preparation for pregnancy, 11 (19.0 %) pregnant women in the first trimester, 33 (56.9 %) pregnant women in the second trimester, and 34 (58.6 %) pregnant women in the third trimester. Study inclusion criteria were as follows: high titers of antiphospholipid antibodies (APA) as well as included non-inclusion criteria in pregnant women with miscarriages and unfavorable anamnestic pregnancy outcome. 36 (62.1 %) women had pregnancy loss in anamnesis. All patients received low-dose ASA and LMWH therapy; 15 (25.86 %) pregnant women also received courses of intravenous immunoglobulins in the first and second trimesters.Results. 47 pregnant women had delivery, whereas 10 of women had pregnancy in progress. Term delivery was in 40 (85.1 %) patients, so that 23 (48.9 %) pregnant women had delivery per vias naturales. The average weight of the fetus was 3364.00 ± 393.76 g, height - 52.13 ± 1.82 cm. In 100 % cases, Apgar score was 8 points. 24 (51.1%) pregnant women had delivery via cesarean section. The average blood loss comprised 528.64 ± 166.10 ml. The average fetal weight in group after surgical delivery was 2982.14 ± 582.88 g, average height - 49.14 ± 4.09 cm, the Apgar score - 7.69 ± 0.47 points. Preterm births were observed in 7 (14.9%) cases, all via cesarean section. In 1 case, early fetal death was at gestational age of 8/9 weeks; according to the karyotyping data, a fetal chromosomal abnormality was detected. No severe obstetric complications were observed.Conclusions. Combining plasmapheresis with low dose LMWH and ASA therapy demonstrated high efficacy in treating obstetric APS manifested as high percentage of favorable pregnancy outcomes and low number of obstetric complications.https://www.gynecology.su/jour/article/view/931antiphospholipid syndromeplasmapheresislow molecular weight heparinsintravenous immunoglobulinsrecurrent pregnancy loss |
| spellingShingle | D. R. Eremeeva M. S. Zainulina Yu. S. Dolgova R. A. Shakhaliev O. A. Silvanovich L. A. Pavlova Use of plasmapheresis in treatment of patients with unfavorable anamnestic pregnancy outcomes coupled to antiphospholipid antibodies Акушерство, гинекология и репродукция antiphospholipid syndrome plasmapheresis low molecular weight heparins intravenous immunoglobulins recurrent pregnancy loss |
| title | Use of plasmapheresis in treatment of patients with unfavorable anamnestic pregnancy outcomes coupled to antiphospholipid antibodies |
| title_full | Use of plasmapheresis in treatment of patients with unfavorable anamnestic pregnancy outcomes coupled to antiphospholipid antibodies |
| title_fullStr | Use of plasmapheresis in treatment of patients with unfavorable anamnestic pregnancy outcomes coupled to antiphospholipid antibodies |
| title_full_unstemmed | Use of plasmapheresis in treatment of patients with unfavorable anamnestic pregnancy outcomes coupled to antiphospholipid antibodies |
| title_short | Use of plasmapheresis in treatment of patients with unfavorable anamnestic pregnancy outcomes coupled to antiphospholipid antibodies |
| title_sort | use of plasmapheresis in treatment of patients with unfavorable anamnestic pregnancy outcomes coupled to antiphospholipid antibodies |
| topic | antiphospholipid syndrome plasmapheresis low molecular weight heparins intravenous immunoglobulins recurrent pregnancy loss |
| url | https://www.gynecology.su/jour/article/view/931 |
| work_keys_str_mv | AT dreremeeva useofplasmapheresisintreatmentofpatientswithunfavorableanamnesticpregnancyoutcomescoupledtoantiphospholipidantibodies AT mszainulina useofplasmapheresisintreatmentofpatientswithunfavorableanamnesticpregnancyoutcomescoupledtoantiphospholipidantibodies AT yusdolgova useofplasmapheresisintreatmentofpatientswithunfavorableanamnesticpregnancyoutcomescoupledtoantiphospholipidantibodies AT rashakhaliev useofplasmapheresisintreatmentofpatientswithunfavorableanamnesticpregnancyoutcomescoupledtoantiphospholipidantibodies AT oasilvanovich useofplasmapheresisintreatmentofpatientswithunfavorableanamnesticpregnancyoutcomescoupledtoantiphospholipidantibodies AT lapavlova useofplasmapheresisintreatmentofpatientswithunfavorableanamnesticpregnancyoutcomescoupledtoantiphospholipidantibodies |