Obstetric genetics

Antiphospholipid

Antiphospholipid syndrome

Antiphospholipid syndrome or antiphospholipid syndrome (APS or APLS), an autoimmune disease, occurs when the immune system produces antiphospholipid autoantibodies in the blood, which in turn create blood clots in the blood vessels.

This can be dangerous when there are blood clots in the legs, kidneys, lungs and brain. In pregnant women, Antiphospholipid syndrome can also lead to miscarriage and stillbirth.

Etiology

The mechanism of pathogenesis involves the presence of three abnormal immune proteins (antibodies) in the blood: lupus anticoagulant, anticardiolipin (anticardiolipin) and anti-β2 glycoprotein I (anti-β2 glycoprotein I) antibodies ).

Antibodies normally bind to specific foreign particles and germs, marking them for destruction, but the antibodies in Antiphospholipid syndrome attack the body's own proteins. When these antibodies bind to proteins, the proteins change shape and bind to other molecules and receptors on the cell surface. Binds to immune cells, activates blood clotting and other immune responses.

Antiphospholipid syndrome can occur in the background of patients who have other diseases such as autoimmune disorders, infections or use of certain medications; especially for women in pregnancy when the immune system must change to adapt to the development of the fetus. In addition, it is also possible for this syndrome to appear without symptoms.

EFFECT OF ANTIPHOSPHOLIPID TO PREGNANCY

Pregnant women with Antiphospholipid syndrome are at increased risk of complications during pregnancy. These complications include high blood pressure caused by pregnancy (pre-eclampsia), an underdeveloped placenta (placental failure), premature delivery, or stillbirth (miscarriage). In addition, women with antiphospholipid syndrome have a higher risk of thrombosis during pregnancy than at other times in life. At birth, infants of mothers with antiphospholipid syndrome may be small and low birth weight.

During pregnancy, if the patiences meet the criteria, the pregnant woman will be tested for Antiphospholipids for related indicators such as: Anti Cardiolipin IgM, Anti Cardiolipin IgG, Anti beta 2 glycoprotein IgM, Anti beta 2 glycoprotein IgG, AntiPhospholipid IgM, AntiPhospholipid IgM, LA….

RATIONALE

AntiPhospholipid test helps to determine whether a woman has this syndrome or not so that there can be a preventive treatment plan, ensuring safety for pregnancy and subsequent pregnancies.

In the diagnosis of Antiphospholipid syndrome, the ELISA test is an immunoassay for anticardiolipin IgG and IgM antibodies and beta2-glycoprotein I. ELISA test results combine with lupus anticoagulant test results and clinical findings. help the physician make a diagnosis of the phospholipid syndrome and the possible hypercoagulability associated with pregnancy events in the patient. A positive result indicates the presence of these antiphospholipid antibodies in the patient's blood. If the result is positive, the test should be repeated after 12 weeks to conclude the possibility of thrombosis recurrence. In case there are indicators showing negative results, the patient will be diagnosed and further tested based on the available guideline (Žigon et al., 2015).

TESTING AT GENTIS

Anti Phospholipid: 7 indicators, including:

6 antibody:
AntiPhospholipid IgG
AntiPhospholipid IgM
Cardiolipin IgG
Cardiolipin IgM
Beta-2-Glycoprotein IgG
Beta-2-Glycoprotein IgM
1 anticoagulation: LA (lupus anticoagulant)
Sample: 2ml of blood Time to return results: 36-48 hours

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