Pregnancy course characteristics in women with a history of recurrent miscarriage due to antiphospholipid syndrome

Aim. To evaluate the effect of the plasmapheresis procedures on the course of pregnancy in patients with recurrent miscarriage and antiphospholipid syndrome.  Materials and methods. The study included 137 pregnant women with recurrent miscarriage due to antiphospholipid syndrome. In addition to standard therapy, 73 patients from the main group underwent a course of plasmapheresis procedures using the intermittent method at the pre-conception care stage. In the comparison group, which consisted of 64 patients, plasmapheresis was not performed. The control group included 28 women with a singleton, normal pregnancy, without an aggravated somatic medical history.  Results. A course of plasmapheresis procedures contributed to a 59.9% reduction in the risk of spontaneous abortion due to antiphospholipid syndrome in the first trimester. In the second trimester, the risk of spontaneous miscarriage was 2.7 times lower in the main group compared to the comparison group. Also, in the main group, signs of placental insufficiency, which were detected using ultrasound, were 1.8 times less common. In the third trimester, the risk of premature birth in the comparison group was 1.9 times more common than in the main group. Conclusion. After a course of plasmapheresis in addition to standard therapy, improved hemodynamics, a decrease in the risk of spontaneous abortion, premature birth and the incidence of placental insufficiency were demonstrated. The results of the study allow us to include plasmapheresis in the course of pre-conception care of women with antiphospholipid syndrome.  Keywords: recurrent miscarriage, threat of spontaneous abortion, antiphospholipid syndrome, plasmapheresis, pre-conception care, placental insufficiency.