Contributions
Type: Publication Only
Background
Inherited thrombophilias are the leading cause of maternal thromboembolism and are associated with an increased risk of certain adversy pregnancy outcomes including second and third trimester fetall loss, abruptions, severe intrauterine growth restriction and early onset severe preeclampsia. The antiphospholipid antibody syndrome (APS) is an acquired autoimmune thrombophyllia in which vascular thrombosis and/or reccurent pregnancy losses occur in patients having laboratory evidence for antibodies againts phospholipids or phospholipid-binding protein cofactors in their blood.
Pregnant women with these highly thrombogenic conditions are at very high risk for both thromboembolism and adverse pregnancy outcomes.
Aims
Aim was to determine the presense of inherited or acquired thrombophillias in women with reccurent pregnancy losses (RPL).
Methods
Women with RPL were tested for heterozygosity for the factor V Leiden and prothrombin G 20210A mutations, homo and heterozygosity in the type 1 plasminogen activator inhibitor gene (PAI-1) and the thermolabile variant of the methylentetrahydrofolate reductase gene (MTHFR). They were also tested for deficiencies of protein C, protein S and antithrombin, as well as for antiphospholipid antibodies-anti beta 2 glycoprotein I antibodies, anticardiolipin antibodies and lupus anticoagulant assays.
Results
From January 2011 till January 2015 260 women were tested for the presense of inherited or acquired thrombophillias because of reccurent pregnancy loss or treatment of infertility.
Median age of patients was 33.4 (19-45).
Six women (2.3%) was negative for both inherited or APS and others (97.7%) were positive.
Criteria for APS fullfilled 57 patinets (21.9%), 8 patients (3%) had only APS and 49 patients (97%) had APS with some of inherited thrombophillias.
246 patients (94.6%) were positive for one or more inherited thrombophillias.
99 patients (38.1%) were positive for one inherited thrombophillia: 4 (1.5%) for Factor V Leiden, 2 (0.7%) for prothrombin G 20210A, 47 (18%) for MTHFR and 46 (17.7%) for PAI-1.
133 patients (41.1%) were positive for 2, 13 patients (5%) for 3 inherited thrombophillias.
105 patients (40.3%) with low molecular weight heparin plus aspirin (LMWH/ASA) or ASA alone had successfully pregnancy outcome-live birth.
Summary
Some form of thrombophillia-inherited or acquired was found in most of tested women with reccurent pregnancy loss (97.6%) and 163 patients (62.7%) had more then one thrombophillia.
With adequate anticoagulant therapy patients with these conditions had chance for successfully pregnancy outcome.
Session topic: Publication Only
Type: Publication Only
Background
Inherited thrombophilias are the leading cause of maternal thromboembolism and are associated with an increased risk of certain adversy pregnancy outcomes including second and third trimester fetall loss, abruptions, severe intrauterine growth restriction and early onset severe preeclampsia. The antiphospholipid antibody syndrome (APS) is an acquired autoimmune thrombophyllia in which vascular thrombosis and/or reccurent pregnancy losses occur in patients having laboratory evidence for antibodies againts phospholipids or phospholipid-binding protein cofactors in their blood.
Pregnant women with these highly thrombogenic conditions are at very high risk for both thromboembolism and adverse pregnancy outcomes.
Aims
Aim was to determine the presense of inherited or acquired thrombophillias in women with reccurent pregnancy losses (RPL).
Methods
Women with RPL were tested for heterozygosity for the factor V Leiden and prothrombin G 20210A mutations, homo and heterozygosity in the type 1 plasminogen activator inhibitor gene (PAI-1) and the thermolabile variant of the methylentetrahydrofolate reductase gene (MTHFR). They were also tested for deficiencies of protein C, protein S and antithrombin, as well as for antiphospholipid antibodies-anti beta 2 glycoprotein I antibodies, anticardiolipin antibodies and lupus anticoagulant assays.
Results
From January 2011 till January 2015 260 women were tested for the presense of inherited or acquired thrombophillias because of reccurent pregnancy loss or treatment of infertility.
Median age of patients was 33.4 (19-45).
Six women (2.3%) was negative for both inherited or APS and others (97.7%) were positive.
Criteria for APS fullfilled 57 patinets (21.9%), 8 patients (3%) had only APS and 49 patients (97%) had APS with some of inherited thrombophillias.
246 patients (94.6%) were positive for one or more inherited thrombophillias.
99 patients (38.1%) were positive for one inherited thrombophillia: 4 (1.5%) for Factor V Leiden, 2 (0.7%) for prothrombin G 20210A, 47 (18%) for MTHFR and 46 (17.7%) for PAI-1.
133 patients (41.1%) were positive for 2, 13 patients (5%) for 3 inherited thrombophillias.
105 patients (40.3%) with low molecular weight heparin plus aspirin (LMWH/ASA) or ASA alone had successfully pregnancy outcome-live birth.
Summary
Some form of thrombophillia-inherited or acquired was found in most of tested women with reccurent pregnancy loss (97.6%) and 163 patients (62.7%) had more then one thrombophillia.
With adequate anticoagulant therapy patients with these conditions had chance for successfully pregnancy outcome.
Session topic: Publication Only