Abstract :

Introduction: APLA have been associated with a number of obstetric complications however their  role  in  the  pathogenesis  of  preeclampsia  has  remained  an  issue  of controversy. There is a lack of information on APLA in pre-eclamptic women.

Objective: To assess the association between antiphospholipid antibodies (APLA) and preeclampsia (PE) in females presenting for antenatal check-up.

Materials and Methods: This Case Control study was conducted in Services Institute of Lahore. After approval from hospital ethical committee, 200 females, fulfilling the inclusion criteria were included in the study from OPD of Department of Obstetrics & Gynecology. Informed consent was obtained. Demographic information was also recorded. The females were divided in two groups on the basis of presence or absence of PE i.e. cases and controls.

Results: The mean age of the patients among cases was 27.60±4.96 years the minimum age was 20 years and maximum was 35 years whereas among controls the mean age of the patients was  27.94±4.13 years the minimum age was 20 years and maximum was 35 years .The mean gestational age among cases was 27.46± 4.72 weeks the minimum gestational age was 20 weeks and maximum was 35 weeks on the other side the mean gestational age among controls was 27.25± 4.74 weeks the minimum gestational age was 20 weeks the maximum was 35 weeks. There was significant association between preeclampsia and APLA as the p-value was significant (p-value=0.007).

Conclusion: Results of this study showed a significant association and significant risk between APLA and preeclampsia. Therefore a routine assay of APLA in women at  risk  of  preeclampsia should be done. However  APLA  testing  should  be  considered  in  women  with  early  onset  severe  preeclampsia,  especially  when  additional  clinical features of APS are present.

---

Keywords :

Antenatal Check-up, Antiphospholipid Antibodies (APLA), Preeclampsia (PE)

---

References :

1. Abou-Nassar K, Carrier M, Ramsay T, Rodger MA. The association between antiphospholipid antibodies and placenta mediated complications: a systematic review and meta-analysis. Thromb Res 2011;128(1):77-85.
2. Ruiz-Irastorza G, Crowther M, Branch W, Khamashta MA. Antiphospholipid syndrome. The Lancet 2010;376(9751):1498-509.
3. Clark EA, Silver RM, Branch DW. Do antiphospholipid antibodies cause preeclampsia and HELLP syndrome? Curr Rheumatol Rep 2007;9(3):219-25.
4. Fischer-Betz R, Specker C, Brinks R, Schneider M. Pregnancy outcome in patients with antiphospholipid syndrome after cerebral ischaemic events: an observational study. Lupus 2012;21(11):1183-9.
5. Cohen D, Berger SP, Steup-Beekman GM, Bloemenkamp K, Bajema IM. Diagnosis and management of the antiphospholipid syndrome. Br Med J 2010;340(7756):1125-32.
6. Salehi R, Asl AA, Alizadeh M, Sayyahmelli M, Azarfarin R. Comparison of Antiphospholipid Antibodies in Hypertensive with Normotensive Pregnant Women. Rawal Med J 2007;32:173-5.
7. Benedict N, Augustina AO, Emefiele AM, Alexander NI. Antiphospholipid Antibodies in Women with Preeclampsia Seen at the University of Benin Teaching Hospital, Benin City, Nigeria. Int J Health Sci Res 2014;4(2):140-8.
8. Dreyfus M, Hedelin G, Kutnahorsky R, Lehmann M, Viville B, Langer B, et al. Antiphospholipid antibodies and preeclampsia: a case-control study. Obstet Gynecol 2001;97(1):29-34.
9. Laganà AS, Favilli A, Triolo O, Granese R, Gerli S. Early serum markers of pre-eclampsia: are we stepping forward? The Journal of Maternal-Fetal & Neonatal Medicine 2015:1-5.
10. Sibai BM. Diagnosis and management of gestational hypertension and preeclampsia. Obstetrics and gynecology 2003;102(1):181-92.
11. Ness RB, Roberts JM. Heterogeneous causes constituting the single syndrome of preeclampsia: a hypothesis and its implications. American journal of obstetrics and gynecology 1996;175(5):1365-70.
12. Vatten LJ, Skjærven R. Is pre‐eclampsia more than one disease? BJOG: an International Journal of Obstetrics & Gynaecology 2004;111(4):298-302.
13. Villar J, Betran A, Gulmezoglu M. Epidemiological basis for the planning of maternal health services. WHO/RHR 2001;111:298-02.
14. Khedun S, Moodley J, Naicker T, Maharaj B. Drug management of hypertensive disorders of pregnancy. Pharmacology & therapeutics 1997;74(2):221-58.
15. Sibai BM. Magnesium sulfate prophylaxis in preeclampsia: lessons learned from recent trials. American journal of obstetrics and gynecology 2004;190(6):1520-6.
16. Obstetricians ACo, Gynecologists. Hypertension in pregnancy. Report of the American college of obstetricians and gynecologists’ task force on hypertension in pregnancy. Obstetrics and gynecology 2013;122(5):1122.
17. Program NHBPE. Report of the national high blood pressure education program working group on high blood pressure in pregnancy. American journal of obstetrics and gynecology 2000;183(1):s1-s22.
18. Rodriguez-Thompson D, Lieberman ES. Use of a random urinary protein-to-creatinine ratio for the diagnosis of significant proteinuria during pregnancy. American journal of obstetrics and gynecology 2001;185(4):808-11.
19. Eiland E, Nzerue C, Faulkner M. Preeclampsia 2012. Journal of pregnancy 2012;2012.
20. Steegers EA, von Dadelszen P, Duvekot JJ, Pijnenborg R. Pre-eclampsia. The Lancet 2010;376(9741):631-44.
21. Organization WH. WHO recommendations for prevention and treatment of pre-eclampsia and eclampsia.
22. Organization WH. The World health report: 2005: make every mother and child count: overview.