PREDICTION OF PREGNANCY OUTCOMES AND OPTIMIZATION OF TREATMENT TACTICS IN WOMEN WITH RECURRENT PREGNANCY LOSS ASSOCIATED WITH ANTIPHOSPHOLIPID SYNDROME

Abstract

Recurrent pregnancy loss (RPL) remains a major challenge in obstetrics, significantly affecting the reproductive health and psychological well-being of women worldwide. Among the various etiological factors, antiphospholipid syndrome (APS) is recognized as one of the most important acquired causes, associated with both early and late pregnancy complications. This study is devoted to the evaluation of prognostic factors and the optimization of treatment strategies in women with RPL associated with APS, based on modern clinical and interdisciplinary approaches. The research included a comparative analysis of patients receiving standard therapy and those managed with individualized, risk-based treatment protocols. The study assessed clinical history, laboratory markers, including antiphospholipid antibody profiles, and instrumental parameters such as Doppler ultrasound findings. Special attention was given to the role of integrated therapeutic strategies, including low-dose aspirin, low molecular weight heparin, and adjunctive therapies such as hydroxychloroquine and corticosteroids in selected cases. The results demonstrated that individualized treatment significantly improves pregnancy outcomes, particularly by increasing live birth rates and reducing the incidence of miscarriage, preeclampsia, intrauterine growth restriction, and preterm delivery. The findings also indicate that early risk stratification and continuous monitoring are essential components of successful pregnancy management in APS. Improved uteroplacental blood flow and stabilization of coagulation parameters observed in the experimental group further support the effectiveness of optimized therapeutic approaches.

Moreover, the study highlights the importance of integrating immunological, hematological, and obstetric data for accurate prognosis and personalized care. The use of adjunctive immunomodulatory therapy, especially in high-risk patients, contributes to better maternal and fetal outcomes by addressing both thrombotic and inflammatory mechanisms of APS. In conclusion, the implementation of individualized, evidence-based treatment strategies significantly enhances pregnancy outcomes in women with APS-associated recurrent pregnancy loss. The study emphasizes the necessity of a multidisciplinary approach and supports the broader adoption of personalized medicine in obstetric practice.