Optimization of treatment of antiphospholipid syndrome in pregnant women: Clinical research
DOI:
https://doi.org/10.37800/RM.1.2025.420Keywords:
antiphospholipid syndrome, pregnancy, systemic enzyme therapy (SET), plasmapheresisAbstract
Relevance: Antiphospholipid syndrome (APS) is a very complex and urgent problem during pregnancy. APS is characterized by venous and arterial thromboses caused by the circulation of antiphospholipid antibodies in the blood. These thromboses lead to various complications and negative consequences of pregnancy, requiring improved therapy.
The study aimed to optimize management of antiphospholipid syndrome in pregnant women.
Materials and Methods: The study was conducted among 76 pregnant women with APS, divided into 2 groups. The groups were representative regarding age, parity, obstetric, and somatic pathology but differed in treatment methods. The comparison group (traditional therapy) included 28 pregnant women with APS. In this group, all pregnant women received traditional APS therapy, including anticoagulants, antiplatelet agents, and glucocorticoids. The main group included 48 pregnant women with APS. In this group, all pregnant women, in addition to traditional therapy, were given systemic enzyme therapy (SET) and plasmapheresis. The control group included pregnant women with uncomplicated pregnancy, n=30.
Results: After 30 days of treatment, the changes in the traditional therapy group compared to the controls included the increases in Willebrand factor – by 17.7%, platelet aggregation index – by 24.1%, total platelet aggregation index – by 26.2%, soluble fibrin-monomer complexes (SFMC) – by 55.3%, and early fibrin degradation products (EFDP) – by 45.6% (p<0.05). The platelet disaggregation index decreased by 18.5% and antithrombin III activity by 14.3% (p>0.05). Multidirectional trends in hemostasis system parameters recorded during traditional therapy generally aggravated the degree of disturbances registered in the initial period of the study.
The treatment provided more significant dynamics toward normalizing the studied parameters in the main group. Reliable differences were revealed with the indicators obtained with traditional therapy: SFMC – by 29.7%, EFDP – by 23.3%, and blood prothrombin time – by 14.0% (p<0.05).
Conclusion: Using SET in combination with plasmapheresis and low molecular weight heparin ensures the normalization of hemostasis system parameters in pregnant women with APS.
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