RELATION OF ANTIPHOSPHOLIPID ANTIBODY AND PLACENTAL BED INFLAMMATORY VASCULAR CHANGES TO THE OUTCOME OF PREGNANCY IN SUCCESSIVE PREGNANCIESOF 2 WOMEN WITH SYSTEMIC LUPUS-ERYTHEMATOSUS

Histological changes in biopsies from the placenta and placental bed i n 2 successive pregnancies of 2 women with systemic lupus erythematosu s and antiphospholipid antibodies were studied. In one of the first 2 pregnancies vasculitis was found in the spiral arteries of the placent al bed biopsy, while the other showed perivascular inflammatory infilt ration and deciduitis. This was associated with poor pregnancy outcome and elevated antiphospholipid antibodies (aPL). In the subsequent 2 p regnancies prednisolone treatment was tailored to suppress the aPL tit er with markedly decreased inflammatory changes and no evidence of vas culitis in the spiral arteries of the placental bed was found. This wa s associated with a normal pregnancy outcome. A causal relationship be tween aPL and inflammatory vascular changes in the placental bed as we ll as a beneficial effect of the corticosteroid treatment in those two women is suggested.