Verspyck E, Marpeau L
Service de gynécologie-obstétrique, CHU Charles Nicolle, 76000 Rouen cedex, France.
Rev Med Interne. 2005 Feb;26(2):103-8. doi: 10.1016/j.revmed.2004.10.001.
Hereditary thrombophilia as antiphospholipid syndrome (APS) may represent a new risk factor for placental vascular diseases.
General screening for biological abnormalities related to thrombophilia is poorly associated with placental vascular diseases and therefore, may be unwarranted. Women with an history of thrombotic diseases may be at risk for late fetal loss or preeclampsia. Adverse obstetric outcomes are particularly high despite anticoagulation regimens in patients with APS. A high frequency for biological abnormalities related to thrombophilia was detected in pregnancies complicated by late fetal loss in comparison with controls. However, no beneficial strategy prevention was clearly reported and therefore, a selective testing was actually debated for these patients.
Searching for acceptable treatment alternatives in patients with APS in order to reduce the high rate for pregnancy complications which may be persistent despite anticoagulation regimens. To determine by controlled studies the role for a prophylactic low molecular weight heparin regimens in patients with haemostatic abnormalities and previous pregnancy complications.
遗传性血栓形成倾向如抗磷脂综合征（APS）可能是胎盘血管疾病的一个新的危险因素。
对与血栓形成倾向相关的生物学异常进行常规筛查与胎盘血管疾病的关联性较差，因此可能没有必要。有血栓形成疾病史的女性可能有晚期胎儿丢失或先兆子痫的风险。尽管APS患者采用了抗凝方案，但不良产科结局的发生率仍特别高。与对照组相比，在并发晚期胎儿丢失的妊娠中检测到与血栓形成倾向相关的生物学异常的频率较高。然而，目前尚无明确报道的有效预防策略，因此，对于这些患者是否进行选择性检测实际上存在争议。
为APS患者寻找可接受的治疗替代方案，以降低尽管采用抗凝方案仍可能持续存在的高妊娠并发症发生率。通过对照研究确定预防性低分子量肝素方案在有止血异常和既往妊娠并发症的患者中的作用。
