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Clinical and Developmental Immunology
Volume 2013 (2013), Article ID 159124, 9 pages
http://dx.doi.org/10.1155/2013/159124
Review Article

Obstetrical Antiphospholipid Syndrome: From the Pathogenesis to the Clinical and Therapeutic Implications

1Laboratory of Hormonology, Maternity, Geneva University Hospitals, 1211 Geneva 14, Switzerland
2Haemostasis Unit, Geneva University Hospitals, 1211 Geneva 14, Switzerland

Received 13 May 2013; Accepted 8 July 2013

Academic Editor: Guixiu Shi

Copyright © 2013 T. Marchetti et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Antiphospholipid syndrome (APS) is an acquired thrombophilia with clinical manifestations associated with the presence of antiphospholipid antibodies (aPL) in patient plasma. Obstetrical APS is a complex entity that may affect both mother and fetus throughout the entire pregnancy with high morbidity. Clinical complications are as various as recurrent fetal losses, stillbirth, intrauterine growth restriction (IUGR), and preeclampsia. Pathogenesis of aPL targets trophoblastic cells directly, mainly via proapoptotic, proinflammatory mechanisms, and uncontrolled immunomodulatory responses. Actual first-line treatment is limited to low-dose aspirin (LDA) and low-molecular weight heparin (LMWH) and still failed in 30% of the cases. APS pregnancies should be a major field in obstetrical research, and new therapeutics are still in progress.