The concept of antiphospholipid syndrome and pregnancy
Among the causes of recurrent miscarriagepregnancy special importance given to the influence of the formation of antibodies (autoimmune reactions) to certain phospholipids on its own implantation processes of growth, development of the embryo and fetus during pregnancy and birth outcomes.
The term "antiphospholipid syndrome" is designatedgroup of autoimmune disorders characterized by a significant amount of antibody contained in the plasma phospholipids (APLA) and related to these phospholipids glycoproteins.
Risk factors for the development of antiphospholipid syndrome
One of the factors ofantiphospholipid syndrome is a genetic predisposition to the disease. Another important factor is the presence of bacterial or viral infection, which does not exclude the possibility of thrombotic complications.
To implement the pathological processrequires the presence in the body not only antibodies to phospholipids, but also so-called co-factors, which upon binding with the true form antigen-antibody complexes. As a result of various factors external and internal environment (viral infection, cancer, effects of drugs) interacts with antiphospholipid antibodies cofactors, which leads to serious disturbances in the blood clotting system. In this case, first of all, disturbed microcirculation and there are variations in the vascular wall.
Types of antiphospholipid syndrome
There are primary and secondary antiphospholipidsyndrome. The presence of secondary antiphospholipid syndrome is caused by autoimmune diseases (systemic lupus erythematosus, periarteritis nodosa, etc..), Cancer, infectious diseases, as well as the impact of a number of drugs and toxic substances. Accordingly, when the primary antiphospholipid syndrome listed diseases and conditions are absent.
In some cases, a so-called isolatedcatastrophic antiphospholipid syndrome, which is characterized by suddenly emerging and rapidly developing failure in vital organs, most often in response to factors such as infectious diseases or surgical interventions. Catastrophic antiphospholipid syndrome manifested acute cerebral and coronary circulation (blood supply to the heart), stupor (depression of consciousness), disorientation, may develop acute renal and adrenal insufficiency, thrombosis of large vessels.
Symptoms and complications of the disease
One of the main and most dangerous manifestationsdisease is often recurrent and recurrent thrombosis. Most often, there are venous thrombosis, localized in the deep veins of the legs, which is associated with risk of developing thromboembolic pulmonary artery branches. However, there are cases of thrombosis of the renal and hepatic veins. There may be thrombotic lesions portal, subclavian, inferior caval vein, brain blood vessels, arteries and veins of the retina, the large vessels of the lower extremities, different aorta. The clinical manifestations of arterial thrombosis are peripheral gangrene, aortic arch syndrome, blindness, cerebral circulatory disorders, and others. The risk of thrombotic complications increases with pregnancy and the postpartum period.
It is known that antiphospholipid syndrome resultingto the developing pregnancy, intrauterine growth retardation, until his death of the fetus in the II and III trimester. In the I trimester of pregnancy is antiphospholipid antibodies may have a direct deleterious effect on the ovum, followed by spontaneous abortion.
From early pregnancy there is an increaseplatelet functional activity and hormonal belkovosinteziruyuschaya reduced placental function. In the absence of appropriate treatment joins the increased activity of the blood coagulation system. This gives rise to thrombosis in the vessels of the placenta, placental insufficiency develops, chronic hypoxia and fetal death is often due to lack of oxygen.