Prevalence of Thrombophilia in Patients with Adverse Pregnancy Outcome
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 6, Issue 5
Abstract
Background: Thrombophilia is hereditary and acquired conditions that predispose the patients to thrombosis. Pregnancy is hypercoagulable state. The tendency to thrombosis develops rapidly in adverse conditions in pregnancy and has been linked to many aspects of pregnancy. It is recently shown that severe pregnancy complications such as severe preeclampsia intrauterine growth retardation abruptio placentae and stillbirth have been shown to be associated with thrombophilia. Recurrent miscarriage has also been associated with thrombophilia. Finally, thromboembolism in pregnancy as in the non-pregnant state is linked to thrombophilia. Aim of the Study: This study aims to study the prevalence of acquired and inherited thrombophilia in women with adverse pregnancy outcome (APO) and their diagnosis with the help of biological markers. The objective was also to study the incidence of each type of thrombophilia in patients with APO. Materials and Methods: A total of 69 patients with a history of APO in previous pregnancies were included in this study to understand the prevalence of hemophilia in them. Various thrombophilic studies were undertaken using the blood samples of the patients. They included anticardiolipin antibodies test, lupus anticoagulant (LAC) test, protein C assay, protein S assay, activated protein C-resistant test, antithrombin assay, homocysteine estimation, prothrombin gene mutation test, anti-β-2 glycoprotein antibodies assay, Proglobal C assay, and factor V Leiden (FVL) mutation test. Based on the test results, the type of thrombophilia was diagnosed, analyzed, and compared with other studies. Observations and Results: A total of 69 patients with a history of APO were screened for inherited and acquired thrombophilia. The patients were enrolled over a period of 2 years from July 2006 to June 2008 from the OPD at the Department of Obstetrics and Gynaecology, AIIMS, New Delhi. Recurrent abortion in 32 (58.18%) patients was the most common APO in women screened for thrombophilia. Other AOPs observed were intrauterine death of fetus (IUD) in 17 (24.63%), intrauterine growth retardation (IUGR) in 11 (15.94%), and severe preeclampsia in 9 (13.04%). The mean gravidity of the patients was 3.7 ± 1.25. The mean gestation of the patients with recurrent abortion was 3.81 ± 0.86, while that for patients with IUD was 3.41 ± 1.12, with IUGR it was 4 ± 0.89 and preeclampsia it was 4.33 ± 0.87. The thrombophilic tests were positive in 33/69 (47.82%) patients in the study, and among them, there were 8/69 (10.14%) patients with inherited thrombophilia in the present study. Protein C deficiency in 4 (5.79%) patients, hyperhomocysteinemia in 2 (2.89%), antithrombin III deficiency in 1 (1.44%), and FVL mutation in 1 (1.44%) patients each. 25 patients tested positive for Anti-β-2 glycoprotein antibodies, nine patients for ACL, and two for LAC. Conclusions: Thrombophilia is common among patients with APO. Inherited thrombophilia is less common than the acquired ones. Biomarkers such as protein C deficiency, hyperhomocysteinemia, antithrombin III deficiency, and FVL mutation help to diagnose inherited type and treat these patients early. Among the acquired thrombophilia patients, anti-β-2 glycoprotein antibodies were positive as biomarker in majority of acquired type of thrombophilia. Other markers useful are anticardiolipin antibodies and deficient LAC.
Authors and Affiliations
S Sooraj
Keywords
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