Screening and diagnosis

Classification and risk stratification

Perioperative care

Quality improvement

Patient education

Nonpharmacologic interventions

Therapeutic procedures

Respiratory support

Follow-up and surveillance

Specific circumstances

Preventative measures

Medical management

Surgical interventions

Inpatient care

Diagnostic procedures

Diagnostic investigations

Insufficient evidence to make a recommendation.

Strongly favor this test or intervention.

The antiphospholipid syndrome (APS) classification criteria tool assesses whether an individual meets the international Sydney criteria for diagnosing APS. The tool requires input in three areas: laboratory findings, thrombotic events, and obstetrical history.

The user must respond to three input categories:

- Laboratory criteria involve detecting certain antibodies, with options including:
  - Positive lupus anticoagulant
  - Elevated anticardiolipin antibodies
  - Elevated anti-beta-2-glycoprotein antibodies

- Thrombotic criteria consider types of clotting events, which include:
  - Arterial thrombosis
  - Venous thrombosis
  - Small vessel thrombosis

- Obstetrical criteria focus on pregnancy-related complications, such as:
  - Three or more unexplained miscarriages at less than 10 weeks gestation
  - One or more unexplained fetal deaths after 10 weeks gestation
  - One or more preterm births before the 34th week due to preeclampsia or placental insufficiency

To determine if the diagnostic criteria are met, at least one laboratory criterion must be present. Additionally, there must be either a history of thrombotic events or specific obstetrical complications. The logic is straightforward: 

If any laboratory criterion is selected and there is at least one thrombotic or obstetrical criterion present, the tool concludes that the diagnostic criteria are met for APS. Otherwise, these criteria are not met. This evaluation ensures the broad criteria established in the Sydney guidelines are covered by confirming both laboratory and clinical manifestations. 

Effectively, this method verifies whether the combination of laboratory and clinical data suffices to diagnose APS according to established standards. The outcome provides a clear indication of whether the criteria are satisfied based on the supplied data.

The calculator in question is the Classification Criteria for Antiphospholipid Syndrome, also known as the Sydney Criteria. This scoring system is used specifically in patients suspected of having antiphospholipid syndrome (APS), a disorder of the immune system that causes an increased risk of blood clots.

The Sydney Criteria is clinically useful in diagnosing APS and determining the need for anticoagulant therapy. It includes both clinical criteria (vascular thrombosis and pregnancy morbidity) and laboratory criteria (presence of antiphospholipid antibodies). A diagnosis of APS requires at least one clinical and one laboratory criterion to be met.

Exclusion criteria for the use of the Sydney Criteria include the presence of other conditions that could explain the clinical manifestations, such as systemic lupus erythematosus. Additionally, the antiphospholipid antibodies should be present on two or more occasions at least 12 weeks apart, so transient presence of these antibodies does not meet the criteria.

Classification criteria for antiphospholipid syndrome (Sydney criteria)

Recurrent pregnancy loss

Management of unexplained RPL

Caffeine restriction

Management of antiphospholipid syndrome

Management of glucose metabolism impairment

Male partner evaluation

Thrombophilia evaluation

Thrombophilia evaluation, antiphospholipid syndrome

Management of uterine abnormalities

Management of uterine abnormalities, uterine septum

Management of uterine abnormalities, uterine fibroids

Infection screening

Endocrinological evaluation

Endocrinological evaluation, thyroid

Products of conception genetic testing

Preimplantation genetic screening

Definition

Physical activity

Diagnostic imaging

Diagnostic imaging, pelvic ultrasound

Diagnostic imaging, further investigations

Management of hyperprolactinemia

Management of thyroid dysfunction

Management of thyroid dysfunction, thyroid autoimmunity

Management of cervical insufficiency

Management of thyroid dysfunction, subclinical hypothyroidism

Management of luteal phase insufficiency

Parental karyotyping

Alcohol restriction

Thrombophilia evaluation, inherited causes

Weight loss

Immunological evaluation

Management of uterine abnormalities (congenital anomalies)

Endocrinological evaluation, prolactin

Management of thyroid dysfunction (overt hypothyroidism)

Management of male partner

Thromboprophylaxis

Management of uterine abnormalities (acquired anomalies)

Management of vaginal bleeding

Vitamin supplements

Management of inherited thrombophilia

Psychological counseling

Smoking cessation

Counseling on risks

Management of uterine abnormalities (intrauterine adhesions)

Prognosis

Endocrinological evaluation (other)

Management of chromosomal rearrangements

Medical history

Recurrent pregnancy loss

Guidelines

Key sources