Alternative for Paraclinical Diagnosis in Suspected Antiphospholipid Antibody Syndrome in Women with Arrested Pregnancies
Author(s): Randriamahazo Rakotomalala Toky, Rainibarijaona Lanto Nirina Aime, Raherinaivo Anjatiana Annick, Rajaonatahina Davidra, Rakotovao Luc, Andrianampanalinarivo Hery Rakotovao, Rasamindrakotroka Andry
Introduction: Antiphospholipid antibodies are a heterogeneous group of circulating antibodies that recognize phospholipids and phospholipid-binding proteins as antigen. Anti-phospholipid antibodies have been found in 6% of women with obstetrical pathologies. In Madagascar, no studies have been conducted regarding the prevalence of antiphospholipid antibodies in terminated pregnancies. The objective of our study is to find an alternative for the paraclinical diagnosis of antiphospholipid antibodies in women with unexplained recurrent pregnancies at the University Hospital of Gynecology and Obstetrics Befelatanana (CHUGOB).
Material and Methods: The study was a prospective descriptive study on the search for lupus anticoagulant in all patients with an arrested pregnancy who were admitted to the gynecology department of CHUGOB during the month of March 18, 2019 to October 09, 2019. Epidemiological parameters were studied such as age, gestational age, gestational age, parity, number of abortions but also medical history and biological parameters prolongation of the aPTT and elevated RPR.
Results: During the study period, During our study period we included 100 patients, The median gestational age of our study population was 27 days with a minimum of 10 days and a maximum of 40 days with a predominance of spontaneous abortions (55%) over in-utero fetal deaths (45%). In the biological analyses, 3% of the patients had an APTT ratio greater than 1.2. After correction, one case had a Rosner index of 29.1. Three cases of RPR positivity with a low titre without TPHA positivity were found.One patient with disseminated lupus erythematosus had an uncorrected prolonged APTT and a positive RPR with a low titre.
Conclusion: the prolonged aPTT, the use of the false positive syphilis serological test for the detection of aCL can be an inexpensive alternative, but does not allow the presence of aCL to be affirmed with certainty.