Use of plasmapheresis and intravenous immunoglobulins in pregnant women with antiphospholipid syndrome
Objective. Demonstrate the efficiency of therapy for antiphospholipid syndrome (APS) in pregnant women using plasmapheresis and intravenous immunoglobulins. Materials and methods. 92 women with diagnosed APS and 47 women without APS with physiological pregnancy were examined. Patients were divided...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | Russian |
| Published: |
St. Petersburg branch of the Russian Association of Allergologists and Clinical Immunologists
2019-08-01
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| Series: | Медицинская иммунология |
| Subjects: | |
| Online Access: | https://www.mimmun.ru/mimmun/article/view/2893 |
| Summary: | Objective. Demonstrate the efficiency of therapy for antiphospholipid syndrome (APS) in pregnant women using plasmapheresis and intravenous immunoglobulins. Materials and methods. 92 women with diagnosed APS and 47 women without APS with physiological pregnancy were examined. Patients were divided into groups depending on the method of treatment used: only standard therapy, plasmapheresis in addition to standard therapy, intravenous immunoglobulins (IVIG) in addition to standard therapy, and complex treatment - plasmapheresis and IVIG in addition to standard therapy. In serum and plasma of peripheral blood, the level of antiphospholipid antibodies, hemostasis parameters, P-selectin, before and after treatment were studied. Results. A higher frequency of favorable pregnancy outcomes was shown in the group of patients with APS who were treated with combined therapy - 96.3% (term birth ). It was found that the most significant decrease in the level of antiphospholipid antibodies was observed in the group with combined use of plasmapheresis, IVIG and traditional therapy. In women with a normal pregnancy without antiphospholipid antibodies, the expression of P-selectin was significantly lower compared to pregnant women with APS. Conclusion. The use of an integrated approach using plasmapheresis, intravenous immunoglobulins and standard therapy is the most effective treatment for APS-related miscarriage. The use of this method has reduced the incidence of obstetric complications and improved pregnancy outcomes by increasing the frequency of term births. Analysis of the level of P-selectin before and after treatment makes it possible to determine the level of platelet activation, the effectiveness of the therapy methods and to correct unfavorable indicators of platelet hemostasis during therapy. |
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| ISSN: | 1563-0625 2313-741X |