{
  "abstract": "Objectives Obstetric antiphospholipid syndrome (OAPS) remains a significant cause of pregnancy morbidity and continues to present diagnostic and therapeutic challenges. This study aims to evaluate current clinical practices, definitions, and management strategies employed by clinicians caring for affected women, as well as to identify areas of consensus and variability within real-world settings.Methods The OAPS-CARE study was an international, cross-sectional, web-based survey conducted to gather information from physicians involved in the management of OAPS. The survey evaluated clinician characteristics, definitions of obstetric manifestations, indications and timing for antiphospholipid antibodies (aPL) testing, interpretation of laboratory results, classification criteria used in clinical practice, and therapeutic strategies across various obstetric scenarios. Descriptive analyses were performed.Results A total of 155 clinicians participated, of whom 123 completed the survey; the majority were rheumatologists (46.4%), obstetricians/gynecologists (21.95%), and internists (18.7%). Most worked in university (77.24%) or public hospital (20.33%) settings. The most common issues related to OAPS were recurrent miscarriage, placental insufficiency, preeclampsia, and fetal death. Significant variation existed in how key obstetric symptoms like recurrent miscarriage, fetal death, stillbirth, and recurrent implantation failure are defined. Although many respondents routinely recommend aPL testing after severe pregnancy complications, the timing and interpretation of antibody results vary widely. Tests for lupus anticoagulant, anticardiolipin, and anti-β2-glycoprotein I antibodies were commonly used, although thresholds for clinical relevance varied. Both the updated Sapporo and the 2023 ACR/EULAR classification criteria were frequently used in clinical practice. For treatment, most obstetric cases favored low-dose aspirin combined with prophylactic low-molecular-weight heparin, particularly for patients with double or triple aPL positivity, whereas additional therapies, such as hydroxychloroquine, were used less consistently.Conclusions This international survey underscores considerable variability in the definitions, diagnostic procedures, and management strategies for OAPS within routine practice. Although there is widespread consensus on antithrombotic therapy, disparities in classification criteria and laboratory interpretation underscore the need for more precise, harmonized guidelines and educational initiatives to enhance standardization and patient care in OAPS.Reference Alijotas-Reig J, Miro-Mur F, Hoxha A, Khamashta MA, Shoenfeld Y. 2023 ACR/EULAR classification criteria for antiphospholipid syndrome: more lights rise but shade remains. RMD Open. 2025 Aug 25;11(3):e006014. doi: 10.1136/rmdopen-2025-006014.",
  "authors": [
    {
      "affiliations": [
        "Internal Medicine Unit, Thrombosis and Bleeding Disorder Center, Department of Medicine, University of Padua, Padua, Italy"
      ],
      "name": "Ariela Hoxha"
    },
    {
      "affiliations": [
        "Vall d’Hebron Research Institute (VHIR). Vall d’Hebron Hospital Campus, Barcelona, Spain",
        "Systemic Autoimmune Diseases U, Barcelona, Spain"
      ],
      "name": "Enrique Esteve Valverde"
    },
    {
      "affiliations": [
        "Internal Medicine Unit, Thrombosis and Bleeding Disorder Center, Department of Medicine, University of Padua, Padua, Italy"
      ],
      "name": "Giovanni Gobbo"
    },
    {
      "affiliations": [
        "Systemic Autoimmune Disease Research Unit. Vall d’Hebron Research Institute (VHIR). Vall d’Hebron Barcelona Hospital Cam, Barcelona, Spain"
      ],
      "name": "Francesc Mirò-Mur"
    },
    {
      "affiliations": [
        "Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, August Pi i Sunyer Biomedical Research Inst, Barcelona, Spain"
      ],
      "name": "Ricard Cervera"
    },
    {
      "affiliations": [
        "University Center of Excellence on Nephrological, Rheumatological and Rare Diseases (ERK-net, ERN-Reconnect and RITA-ERN, Turin, Italy"
      ],
      "name": "Massimo Radin"
    },
    {
      "affiliations": [
        "Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento di Scienze per la salute della Donna e del Bambino e, Rome, Italy"
      ],
      "name": "Sara De Carolis"
    },
    {
      "affiliations": [
        "Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spanish Network in Maternal, Neonatal, Chil, Barcelona, Spain"
      ],
      "name": "Cristina Trilla"
    },
    {
      "affiliations": [
        "UO Reumatologia e Immunologia Clinica ERN ReCONNET ASST-Spedali Civili di Brescia Università degli Studi d Brescia, Brescia, Italy"
      ],
      "name": "Angela Tincani"
    },
    {
      "affiliations": [
        "Systemic Autoimmune Disease Research Unit. Unit. VHIR. Vall d’Hebron Barcelona Hospital Campus. Department of Medicine., Barcelona, Italy"
      ],
      "name": "Jaume Alijotas-Reig"
    }
  ],
  "title": "LBA:01:05 Clinical practice in obstetric antiphospholipid syndrome: results from the international OAPS-CARE survey",
  "uid": "8ddda056-62c2-5ad6-9c55-94fbaa7849ff"
}