PB1398 - Loss of opportunities in the diagnosis and treatment of Primary obstetric antiphospholipid syndrome (POAPS). What is hidden behind the daily clinical practice?

Tuesday, July 12, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Presenting Author(s)

Gabriela F. de Larrañaga, PhD

Dr.
Hospital de Infecciosas F. J. Muñiz
Ciudad Autónoma de Buenos Aires, Ciudad Autonoma de Buenos Aires, Argentina

Co-Author(s)

SU

Sebastián Udry

MD
Acute Hospital "Dr. Carlos G. Durand and Research center “Fundación Respirar”
Ciudad Autónoma de Buenos Aires, Ciudad Autonoma de Buenos Aires, Argentina
SP

Silvia Perés

Dr
Hospital de Infecciosas F. J. Muñiz
Ciudad Autónoma de Buenos Aires, Ciudad Autonoma de Buenos Aires, Argentina
Federico Aranda

Dr
Hospital de Infecciosas F. J. Muñiz
Ciudad Autónoma de Buenos Aires, Ciudad Autonoma de Buenos Aires, Argentina
SM

Stephanie Morales Perez

Dr.
Internal Medicine Althaia Healthcare Network of Manresa
Barcelona, Catalonia, Spain
Cristina Belizna, MD

Dr.
University Hospital Angers
Angers, Pays de la Loire, France
EE

Enrique Esteve-Valverde

Dr.
Fundación Althaia de Manresa
Barcelona, Cantabria, Spain
DF

Diego Santiago Fernández Romero

Dr.
Acute Hospital "Dr. Carlos G. Durand"
Ciudad Autónoma de Buenos Aires, Ciudad Autonoma de Buenos Aires, Argentina
JA

Jaume Alijotas-Reig

Dr.
Valld'Hebron University Hospital
Barcelona, Cantabria, Spain
OL

Omar Latino

Prof.
Acute Hospital "Dr. Carlos G. Durand"
Ciudad Autónoma de Buenos Aires, Ciudad Autonoma de Buenos Aires, Argentina

Background: Patients who meet the clinical criteria for POAPS sometimes are not adequately studied, due to failure on the request of serological studies to make the proper diagnosis. This leads to underdiagnosis of this pathology, exposing patients to new thrombotic and/or obstetric events that would be preventable with a timely diagnosis and a proper treatment.

Aims: To identify and quantify the loss of opportunities, in terms of time, in the diagnosis and treatment of POAPS.

Methods: Ninety-nine POAPS patients [median age: 32 years; (28-37)], strictly according to the international criteria, were studied. Preventable clinical events associated with POAPS during a GAP time were identified through a retrospective analysis. The GAP time was defined as the time between the date when the patient meets the clinical criteria and the date when the diagnosis was finally made.
The number of preventable obstetric/thrombotic events and the GAP time (years) were recorded. Patients were grouped and compared whether they were attended at a Specialized or General Health Center.

Results: During the GAP time 134 pregnancies (56 live births and 78 pregnancy losses) and 87 preventable events were registered (46 miscarriages, 32 fetal losses and 9 premature deliveries before the 34th weeks due to preeclampsia or placental insufficiency and 1 thrombosis).
The mean GAP time (± SD) was 4.27 years ± 3.58 (range: 0-21 years). A number of 20.37 preventable events per year /100 patients was estimated.
Remarkably, all patients that presented with preventable events were not attended at specialized health centers.

Conclusion(s): The underdiagnosis of POAPS leads to the occurrence of preventable obstetric events, a loss of time resulting in a loss of lives. We consider that it mainly because of a lack of knowledge on the diagnostic criteria for POAPS from the medical staff and the lack of diagnostic support in General health centers.