Antiphospholipid Syndrome (APS) is a medical condition that often does not appear easily at the surface of clinical situations, even though it may be present. It does not have the instant recognisability of diabetes, hypertension, or thyroid disorders, yet its impact can be life-changing, particularly for women in their reproductive years.
Understanding APS
APS is an autoimmune disorder in which the body mistakenly produces antibodies that attack phospholipids, a type of fat essential for normal blood vessel function. This deviation leads to an increased tendency of blood clot formation in both veins and arteries. If unnoticed or not treated , APS can cause complications ranging from deep vein thrombosis to recurrent miscarriages. Its subtle presentation and serious consequences make awareness not just important, but essential.
Although considered rare, APS is not as uncommon as perceived. Studies suggest that APS affects 1–5% of the general population, and up to 10–15% of women with recurrent pregnancy loss test positive for antiphospholipid antibodies. Many individuals live with APS silently until a major event such as a stroke, clot, or miscarriage reveals it. Increased awareness can prompt earlier testing, especially in women who have unexplained pregnancy losses or young individuals with clotting events.
Impacts on pregnancy
One of the most critical reasons to tackle APS is its strong link with pregnancy complications. APS is one of the leading treatable causes of recurrent miscarriages, especially after 10 weeks of gestation. It can also cause:
• Recurrent early pregnancy loss
• Gestational hypertension or eclampsia
• Severe foetal growth restriction
• Preterm delivery due to placental insufficiency
Without awareness, these complications may be taken as “bad luck” or “natural losses.” Timely diagnosis, however, can dramatically improve chances of continuation of pregnancy and healthy outcomes. With proper treatment, which usually consists of low dose aspirin and heparin injections, live birth rates can rise significantly.
Misconceptions, mimicking conditions
A common misconception is that clotting disorders only affect the elderly or those with heart disease. APS defies this belief. Many patients are young, in their 20s or 30s, with none of the traditional risk factors. A sudden deep vein thrombosis (DVT), stroke, or pulmonary embolism in a young adult should prompt evaluation for APS.
Early suspicion and diagnosis can prevent life-threatening complications.
APS can also often mimic other conditions. Because symptoms vary widely — headaches, skin changes, repeated miscarriages, unexplained clots and low platelet count — APS can be confused with other conditions including lupus, thrombophilia, or simple vascular disorders. Misdiagnosis or delayed diagnosis is very common.
Awareness among both patients and healthcare providers helps ensure that individuals with “unexplained” symptoms are tested for antiphospholipid antibodies, including: lupus anticoagulant (LA), anticardiolipin antibodies (aCL) and anti-β2 glycoprotein I antibodies.
A diagnosis requires persistent positivity in two tests at least 12 weeks apart, highlighting the need for structured evaluation rather than one-time testing.
How is it treated?
APS is not curable, but it is manageable. Treatment aims to reduce clot risk and ensure safe pregnancies. Depending on the severity, management may include:
• Low-dose aspirin
• Heparin injections during pregnancy
• Warfarin for long-term anticoagulant in non-pregnancy conditions
• Lifestyle modifications (hydration, avoiding smoking, mobility on long flights)
With proper treatment, individual with APS can lead completely normal life. The key is early detection.
Building awareness
Many women suffer repeated pregnancy losses without being offered APS testing. Many young men and women experience unexplained strokes or DVTs that could have been prevented. Awareness can shift this narrative from tragedy to timely intervention.
Healthcare professionals—especially gynaecologists, obstetricians, and physicians—must keep APS in mind during evaluations. Public awareness campaigns can empower patients to ask the right questions.
Understanding APS helps in preventing major blood clotting episodes, improving maternal and foetal outcomes, reducing long-term complications, providing psychological relief to couples with unexplained miscarriages and ensuring personalised, preventive care.
APS may be silent, but its effects are disastrous . Awareness is the first step toward control.
(Dr. Vinoad Bharrati is an obstetrician and gynaecologist and director, Elite Momz Unit of Rising Medicare Hospital, Pune. drvinodbharati@gmail.com)
Published – December 11, 2025 04:45 pm IST