Antiphospholipid Syndrome

What is antiphospholipid syndrome?

Antiphospholipid syndrome (aPL) is an autoimmune disease. It causes the body to make large amounts of antiphospholipid antibodies. Phospholipids are a special kind of fat that contains phosphate. Phospholipids make up the outer walls of the body's cells. Antiphospholipid antibodies attack the phospholipids. This causes many different problems. One problem is that your blood clots too easily. Your body may also make anticardiolipin antibodies. Cardiolipin is a type of phospholipid.

This disease often causes:

  • Thrombosis. This happens when blood clots form in your arteries or veins (especially in the legs). If clots form in the blood vessels that in the brain and spinal cord, you could have a stroke.

  • Thrombocytopenia. This happens when your blood is low in platelets. Platelets are cells that help your blood form clots.

  • Pregnancy loss. This can happen several times.

Antiphospholipid syndrome is sometimes called Hughes syndrome, or sticky blood syndrome. You can get it if you have another autoimmune disease, such as systemic lupus erythematosus (SLE, or lupus).

Antiphospholipid syndrome is often difficult to diagnose. Blood tests for lupus anticoagulant, anticardiolipin antibody, and anti-β2-glycoprotein may help your doctor make a diagnosis.

How does pregnancy affect antiphospholipid syndrome?

It is not clear whether aPL gets worse or stays the same when you get pregnant.

How does antiphospholipid syndrome affect pregnancy?

This disease can cause serious problems during pregnancy for both you and your baby. Women who get aPL are also at risk for other problems. Some of these are:

  • Stroke

  • Blood clots

  • High blood pressure in pregnancy (preeclampsia)

  • Stillbirth (fetal death)

  • Multiple miscarriage

  • Poor fetal growth (intrauterine growth restriction)

  • Preterm birth

Management of antiphospholipid syndrome during pregnancy

Antiphospholipid syndrome increases your chances of stroke, pregnancy loss, and other problems. This means pregnant women need to be watched closely. More frequent prenatal visits are often needed.

Treatment for aPL often includes blood thinner medications. These medications may need to be changed (type and/or dosage) during pregnancy. Ask your health care provider for more information.

If you have aPL, you may need certain tests during your pregnancy. Some of those tests are:

  • Blood tests for aPL (specific antibodies that help show how bad the disease is) to diagnose the condition

  • Blood clotting levels in the blood

  • Checking for signs of gestational hypertension

  • Ultrasound. This test uses high-frequency sound waves and a computer to create images of your blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, to look at blood flow through various vessels, to check your baby’s growth and development, and to check your baby’s well-being.

  • Fetal heart monitoring to check the fetal heart rate for signs of distress

  • Other fetal testing, including Doppler ultrasound flow studies to monitor the blood flow in the uterus and umbilical cord

Women with aPL can increase their chances for a healthy pregnancy by getting early prenatal care and working with their health care providers to manage their disease.