Anticuerpos anti-fosfatidilserina/protrombina en fracaso reproductivo recurrente

Résumé

Anti-phosphatidylserine/prothrombin (aPS/PT) antibodies are autoantibodies that are part of the family of the anti-phospholipid antibodies (aPL). Contrary to lupus anticoagulant, anti-Cardiolipin and anti-Beta-2- Glycoprotein-I, aPS/PT are not included in the latest classification criteria as a laboratory criterion for Anti-Phospholipid Syndrome (APS). It is known that these antibodies could be present in patients with thrombosis who are negative for other aPL. The results found in this PhD thesis broaden the interest of aPS/PT determination to show utility in the field of recurrent miscarriages and implantation failure. We found a significant prevalence of aPS/PT and a statistically significant association with all the clinical phenotypes of obstetric morbidity within APS, both in the univariate and multivariate analysis compared to age and aPL included in the laboratory criteria. Patients positive for aPL including aPS/PT were treated with similar schemes to other aPL and led to a subsequent successful pregnancy with a live newborn with statistically significant differences compared to therapeutic abstention when the evolution of all aPS/PT patients was considered as a whole as well as in women with spontaneous miscarriages before pregnancy week 10.