Which is not included in pregnancy morbidity due to APLA?

**Core Concept**
Pregnancy morbidity due to Antiphospholipid Antibodies (APLA) syndrome involves a range of complications that occur in pregnant women with APLA, primarily thrombosis and fetal loss. The pathophysiology of APLA syndrome is related to the formation of antiphospholipid antibodies, which lead to the activation of coagulation pathways and endothelial dysfunction.

**Why the Correct Answer is Right**
The correct answer is related to the fact that APLA syndrome is characterized by thrombosis and fetal loss, which are the primary components of pregnancy morbidity. The mechanism involves the activation of coagulation pathways due to the binding of antiphospholipid antibodies to phospholipid-binding proteins, leading to the production of tissue factor and the activation of prothrombin. This results in the formation of thrombi in the placenta and other organs, leading to pregnancy complications.

**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it is not a component of pregnancy morbidity due to APLA syndrome. APLA syndrome does not typically involve direct damage to the kidneys.
**Option B:** This option is incorrect because it is not a primary component of pregnancy morbidity due to APLA syndrome. While APLA syndrome can involve thrombocytopenia, it is not a primary cause of pregnancy morbidity.
**Option C:** This option is incorrect because it is a primary component of pregnancy morbidity due to APLA syndrome. Fetal loss is a common complication of APLA syndrome, due to placental thrombosis and other mechanisms.

**Clinical Pearl / High-Yield Fact**
It is essential to note that APLA syndrome can be diagnosed using specific laboratory tests, including the lupus anticoagulant assay and the anticardiolipin antibody test. APLA syndrome should be considered in pregnant women with unexplained thrombosis or recurrent fetal loss.

**Correct Answer:** C. Fetal loss is a primary component of pregnancy morbidity due to APLA syndrome.

✓ Correct Answer: C. 3 or more unexplained spontaneous aboion before 2nd trimester