EUROAPS
European Registry on Obstetrical Anti-Phospholipid Antibody Syndrome
MRN (Medical Record Number)
The number used by your Hospital to identify the patient's permanent medical/health record file
Your answer
Birthdate
MM
/
DD
/
YYYY
Hospital
(If you are from another Hospital, choose "other" and write below your Hospital. We will add later on the list)
ID EUROAPS
Please don't fill this parameter. Only for database managers.
Your answer
Classification (according to Sydney criteria)
Please don't fill this parameter. Only for database managers.
Ethnics
Age of the patient
Your answer
Smoker
Length
(in centimeters)
Your answer
Total number of previous pregnancies
(1,2,3...)
Your answer
RECURRENT IMPLANTATORY FAILURE
NUMBER OF TRANSFERS
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