[Predictive value of uterine artery velocity waveforms in monitoring of pregnancies with high obstetrical risk antiphospholipid syndrome: the Rouen experience].

OBJECTIVES: Anti-phospholipid syndrome (APLS) and obstetrical complications have been associated for years. The purpose of this study was to define a high obstetrical risk subpopulation of APLS and search predictive criteria of complications likely to improve monitoring of pregnancy.

PATIENTS AND METHODS: We conducted a retrospective study at the CHU of Rouen between 1998 and January 2008. Pregnancies were included for patients with APLS according to the criteria of Sydney without repeated miscarriages item.

RESULTS: The study involved 20 pregnancies from eight patients. Fourteen pregnancies gave birth to living children or 70 %, 28.6 % were complicated with pre-eclampsia, 50 % of haemolysis elevated liver enzymes low platelets (HELLP) syndrome associated with a 28.6 % stunting and 42 % of premature birth. Patients received treatment involving aspirin and heparin. The obstetrical prognosis was significantly poorer in the subgroup with APLS notch bilateral persistent middle of the term of birth of 35.5 versus 28 weeks of gestation, and median birth weight of 950 g versus 2780 g (p<0.05).

DISCUSSION AND CONCLUSION: Patients were selected according to the more specific criteria of APLS (thrombosis and fetal loss) and a history of severe obstetrical complications. In some series, these complications play a major role; in others, they are unsignificant. Rate, in this study, is high (47 %) and the presence of bilateral notch seems to be an excellent predictive marker of vascular complications in this population.