Prevention of recurrent fetal loss caused by antiphospholipid syndrome.

Repeated fetal loss presents a challenge for both patients and health care professionals. Antiphospholipid syndrome (APS) may account for as much as 10% to 48% of recurrent fetal loss. Suggested pathophysiologic mechanisms of APS in fetal loss include the action of autoantibodies, the lupus anticoagulant, and anticardiolipin antibodies on the endothelial cells, which may lead to platelet aggregation, thrombosis, placental infarcts, and subsequently reduced oxygenation to the fetus. This study explores fetal loss caused by APS, its pathophysiologic features, treatment, and nursing implications. Heparin therapy is presented as a method to prevent intrauterine growth retardation and fetal death. The educational and psychosocial needs of patients receiving this therapy and necessary patient follow-up and coordination of services are reviewed.