文献詳細
合併増大号 今月の臨床 生殖医療の基礎知識アップデート―患者説明に役立つ最新エビデンス・最新データ
不育症の検査・治療
文献概要
●不育症患者が,国際基準を満たす抗リン脂質抗体症候群と診断された場合には,未分画ヘパリンを併用したアスピリン療法を行う.
●その他の不育症患者に対するアスピリン療法のエビデンスは確立しておらず,諸家の報告に基づくコンセンサスで行われている.
●治療の基準は今後エビデンスが蓄積されることで変化してゆく可能性があり,情報をアップデートしながら,柔軟に判断する必要がある.
●その他の不育症患者に対するアスピリン療法のエビデンスは確立しておらず,諸家の報告に基づくコンセンサスで行われている.
●治療の基準は今後エビデンスが蓄積されることで変化してゆく可能性があり,情報をアップデートしながら,柔軟に判断する必要がある.
参考文献
1)Fisher M, et al : The dose of aspirin for the prevention of cardiovascular andcerebrovascular events. Curr Med Res Opin 22 : 1239-1248, 2006
2)Askie LM, et al : Fast track-articles : antiplatelet agents for prevention of pre-eclampsia : a meta-analysis of individual patient data. Lancet 369 : 1791-1798, 2007
3)Xu TT, et al : Low-dose aspirin for preventing preeclampsia and its complications : a meta-analysis. J Clin Hypertens 17 : 567-573, 2015
4)Eva N, et al : Aspirin or heparin or both for improving pregnancy outcomes in women with persistent antiphospholipid antibodies and recurrent pregnancy loss. Cochrane Database Syst Rev 5 : CD012852, 2020
5)de Jong PG, et al ; Pregnancy and Childbirth Group : Aspirin and/or heparin for women with unexplained recurrent miscarriage with or without inherited thrombophilia. Cochrane Database Syst Rev 2014 : CD004734, 2014
6)Sugi T, et al : Antiphosphatidylethanolamine antibodies in recurrent early pregnancy loss and mid-to-late pregnancy loss. J Obstet Gynaecol Res 30 : 326-332, 2004
7)Obayashi S, et al : Antiphosphatidylethanolamine antibodies might not be an independent risk factor for further miscarriage in patients suffering recurrent pregnancy loss. J Reprod Immunol 85 : 186-192, 2010
8)Yonezawa M, et al : Significance of anti-phosphatidylethanolamine antibodies in the pathogenesis of recurrent pregnancy loss. Reprod Sci 27 : 1888-1893, 2020
9)Atsumi T, et al : Association of autoantibodies against the phosphatidylserine-prothrombin complex with manifestations of the antiphospholipid syndrome and with the presence of lupus anticoagulant. Arthritis Rheum 43 : 1982-1993, 2000
10)Shi H, et al : Antiphosphatidylserine/prothrombin antibodies(aPS/PT)as potential diagnostic markers and risk predictors of venous thrombosis and obstetric complications in antiphospholipid syndrome. Clin Chem Lab Med 56 : 614-624, 2018
11)Gris JC, et al : Low-molecular-weight heparin versus low-dose aspirin in women with one fetal loss and a constitutional thrombophilic disorder. Blood 103 : 3695-3699, 2004
12)Carp H, et al : Thromboprophylaxis improves the live birth rate in women with consecutive recurrent miscarriages and hereditary thrombophilia. J Thromb Haemost 1 : 433-438, 2003
13)Folkeringa N, et al : Reduction of high fetal loss rate by anticoagulant treatment during pregnancy in antithrombin, protein C or protein S deficient women. Br J Haematol 136 : 656-661, 2007
14)Matsukawa Y, et al : Genotyping analysis of protein S-Tokushima(K196E)and the involvement of protein S antigen and activity in patients with recurrent pregnancy loss.Eur J Obstet Gynecol Reprod Biol 211 : 90-97, 2017
15)Ebina Y, et al : Low levels of plasma protein S, protein C and coagulation factor XII during early pregnancy and adverse pregnancy outcome. Thromb Haemost 114 : 65-69, 2015
16)Croles FN, et al : Pregnancy, thrombophilia, and the risk of a first venous thrombosis : systematic review and bayesian meta-analysis. BMJ 359 : j4452, 2017
17)Morita K, et al : Risk factors and outcomes of recurrent pregnancy loss in Japan. J Obstet Gynaecol Res 45 : 1997-2006, 2019
18)Sato Y, et al : Antigenic binding sites of anti-protein S autoantibodies in patients with recurrent pregnancy loss. Res Pract Thromb Haemost 2 : 357-365, 2018
19)Inomo A, et al : The antigenic binding sites of autoantibodies to factor XII in patients with recurrent pregnancy losses. Thromb Haemost 99 : 316-323, 2008
20)Sato Y, et al : Anti-factor XII autoantibodies in patients with recurrent pregnancy loss recognize the second epidermal growth factor-like domain. TH Open 3 : e263-e272, 2019
21)Yonezawa M, et al : Significance of anti-phosphatidylethanolamine antibodies in the pathogenesis of recurrent pregnancy loss. Reprod Sci 27 : 1888-1893, 2020
掲載誌情報