PLACENTAL PATHOLOGY AND ANTIPHOSPHOLIPID ANTIBODIES - A DESCRIPTIVE STUDY

We described placental pathology in antiphospholipid antibody (APL) sy ndrome, APL and no history of recurrent pregnancy loss, and in treated and untreated pregnancies of APL syndrome. Thirty-nine pregnancies of 28 patients were studied: 23 placentas delivered from 23 women with A PL (13 with APL syndrome and 10 with serological APL); 8 untreated mis carriages before APL diagnosis from 6 of the 13 patients with APL synd rome and 1 of 10 with serological APL; and 8 miscarriages by 5 additio nal women before APL syndrome diagnosis. Histopathology was reviewed b y a pathologist blinded except to gestational age. Contingency tables and analysis of variance (ANOVA) considered p < 0.05 significant. Comp aring the placentas delivered at >18 weeks' gestation, excessive periv illous coagulation, avascular terminal villi, and ch ron ic villitis/u teroplacental vasculitis tended to be more com mon in treated APL synd rome than serological APL cases ip = 0.07). Oi the 16 miscarriages bef ore diagnosis of APL, 11 were lost at <18 weeks' gestation. None had p athology typical of APL, but 4 of 11 (36%) had chronic intervillositis . Five of 16 miscarriages before the diagnosis of APL were miscarried between 18-22 weeks. Three oi 5 (60%) miscarried after 18 weeks had mu ltifocal uteroplacental thromboses, compared to 6 of 13 (46%) treated pregnancies with APL syndrome and 0 of 10 cases with serological APL.