Background/Purpose: To evaluate the efficacy of the treatment on the pregnancy outcomes of women with Rheumatic Diseases and Thrombophilia from a Spanish cohort. Their pregnancies should be considered high obstetric risk and they need close monitoring in a multidisciplinary unit.

Methods: Descriptive, retrospective and open study of 143 patients diagnosed with rheumatic diseases and thrombophilia assisted in a specialized multidisciplinary unit of Rheumatic Diseases and pregnancy (integrated by Gynecologists, Hematologists and Rheumatologists). The following variables were collected: age, maternal pathology, presence of antiphospholipid antibodies (aPL), anti-Ro/La, prior abortions, fetal echocardiograms, treatment during pregnancy, obstetric outcomes births/abortion, pregnancy length and maternal/fetal complications. The statistical analysis was done using the McNemar Test.

Results: 143 pregnant women were included. The baseline characteristics are specified in table 1. Our patients were an average of 33.6±5.44 years old and the 44% were elder than 35 years. 198 pregnancies were developed during the monitoring. Abortions registered are specified in table 2. Before the inclusion in our unit there were 231 abortions with an average of 1.6±1.84 abortions per patient. Only 7 abortions occurred for the patients monitored in our unit. The reduction in the number of abortions was statistically significant (p<0.001). The treatment received is shown in the table 3. 44% pregnant women have higher obstetric risk with an average of 2.48±1.99 abortions per patients. They received treatment with LMWH in combination with ASA and 16 pregnant received also IVIG. The mean gestational age was 38 weeks with an average birth weight of 3058.5±595.6 grams. Only 11% babies were preterm and 34% births were cesarean. 88.4% of our patients did not have complications in the puerperium. All pregnant patients with positive Anti-Ro/La autoantibodies were monitored with periodic fetal echocardiograms from the 16th week of gestation. No Congenital Heart Block or neonatal lupus were registered (100% of newborn were healthy).

Conclusion: The treatment is effective in the decrease in the number of abortions and in a reduction of maternal and fetal morbidity and mortality. The multidisciplinary evaluation is essential in women diagnosed with Rheumatic Diseases and Thrombophilia.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/pregnancy-outcomes-in-women-with-rheumatic-diseases-and-thrombophilia-treated-in-a-multidisciplinary-unit/