Lockshin M D
Barbara Volcker Center for Women and Rheumatic Disease, Hospital for Special Surgery, Cornell Medical Center, New York, NY 10021, USA.
Lupus. 1998;7 Suppl 2:S86-9. doi: 10.1177/096120339800700219.
With the use of low-dose heparin, fetal survival of aPL pregnancies is 70-80%, but prematurity and intrauterine growth restriction are common. It is likely, but not proven, that dysregulated placental coagulation and resultant vasculopathy are the cause of fetal loss. Details of dysregulated coagulation remain to be described. Opportunities remain to determine the role of coagulopathy in repeated pregnancy loss, identify a critical event or window to which intervention might be directed, identify maternal (and fetal) characteristics other than aPL that determine fetal loss, describe toxicity profiles of current treatments, develop more specific, less toxic therapies, and describe long-term fetal and maternal outcomes.
使用低剂量肝素时，抗磷脂抗体（aPL）阳性妊娠的胎儿存活率为70%-80%，但早产和宫内生长受限很常见。胎盘凝血功能失调及由此导致的血管病变很可能是胎儿丢失的原因，但尚未得到证实。凝血功能失调的具体细节仍有待描述。在确定凝血病在复发性流产中的作用、确定可能进行干预的关键事件或窗口期、识别除aPL之外决定胎儿丢失的母体（和胎儿）特征、描述现有治疗的毒性特征、开发更特异、毒性更小的疗法以及描述胎儿和母体的长期结局等方面仍存在机会。
