Prevalence and significance of thrombophilia markers in adverse pregnancy outcome

Authors

  • Anil Kumar Adhikari Department of Obstetrics and Gynecology, IQ City Medical College and NH Multispeciality Hospital, Sovapur, Durgapur, West Bengal- 713206, India
  • Mahuya Dutta Department of Obstetrics and Gynecology, IQ City Medical College and NH Multispeciality Hospital, Sovapur, Durgapur, West Bengal- 713206, India
  • S. K. Samim Ferdows Department of Community medicine, IQ City Medical College and NH Multispeciality Hospital, Sovapur, Durgapur, West Bengal- 713206, India
  • Madhu Jain Department of Obstetrics and Gynecology, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh- 221005, India
  • Jyoti Shukla Department of Pathology, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh- 221005, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20170368

Keywords:

Adverse pregnancy outcome, Thrombophilia, Thrombophilia markers

Abstract

Background: Thrombophilia complicates the pregnancy by interfering the physiology of utero-placental circulation which in turn leads to IUGR, IUD, PIH, RPL, abruption placentae. This study is to find out the prevalence and significance of different thrombophilia markers in cases of adverse pregnancy outcome in eastern part of Uttar Pradesh, India.

Methods: 54 antenatal women are selected from the cases presented with or previous history of PIH, IUGR, IUD, Abruption or early/late abortion. A thorough family history, history of risk factors, clinical examination were noted. Platelet count, prothrombin time(PT), activated partial thromboplastin time (APTT), plasma fibrinogen, factor-VIII assay, LA, ACLA, protein- C, protein- S, TORCH, thyroid profile, blood sugar, USG is done in all patients at the time of first registration. 50 antenatal females without any bad obstetric history was taken as controls.

Results: Among 54 cases, 64.8% cases were positive for thrombophilia markers, whereas 6% control had presence of thrombophilia markers. 6.5% thrombophilia positive cases had ≥3 markers present and had ≥2 manifestations of adverse pregnancy outcome in 100% cases. Prevalence of different thrombophilia markers are studied in individual case and association to various outcomes were noted.

Conclusions: There was high prevalence of thrombophilia markers in the cases with adverse pregnancy outcome. As treatment was found significantly effective in literature, screening of these markers should be done in patients with bad obstetric history.

References

Vora S, Shetty S, Salvi V, Satoskar P, Ghosh K. Thrombophilia and unexplained pregnancy loss in Indian patients. Natl Med J India. 2008;21(3):116-9.

Hossain N, Shamsi T, Soomro N. Frequency of thrombophilia in patients with adverse pregnancy outcome. J Pak Med Assoc. 2005;55:245-7.

Mishra MN, Bedi VS. Prevalence of common thrombophilia markers and risk factors in Indian patients with primary venous thrombosis. Sao Paulo Med J. 2010;128(5):263-7.

Hossain N, Paidas MJ. Adverse pregnancy outcome, the uteroplacental interface, and preventive strategies, seminars in perinatology. Perintolol. 2007;31(4):208-12.

Kupferminc MJ, Eldor A, Steinman N, Many A, Bar-Am A, Jaffa A, et al. Increased frequency of genetic thrombophilia in women with complications of pregnancy. N Engl J Med. 1999;340(1):9-13.

Brenner B. Inherited thrombophilia and pregnancy loss. Thromb Haemost. 1999;82:634-40.

Mustafa S, Mannhalter C, Rintelen C, Kyrle PA, KnoÈbl P, Lechner K, et al. Clinical features of thrombophilia in families with gene defects in protein C or protein S combined with factor V Leiden. Blood Coagulation and Fibrinolysis. 1998;9:85-9.

Koeleman BPC, van Rumpt D, Hamulya´k K, Reitsma PH, Bertina RM. Factor V Leiden: an additional risk factor for thrombosis in protein S deficient families? Thrombosis and Haemostasis. 1995;74:580-3.

Preston FE, Rosendaal FR, Walker ID. Increased fetal loss in women with heritable thrombophilia. Lancet. 1996;348:913-6.

Alfirevic Z, Roberts D, Martlew V. How strong is the association between maternal thrombophilia and adverse pregnancy outcome? A systematic review. Eur J Obstet Gynecol Reprod Biol. 2002;101(1):6-14.

Yasuda M, Takakuwa K, Tokunaga A, Tanaka K. Prospective studies of the association between anticardiolipin antibody and outcome of pregnancy. Obst Gynecol. 1995;86:555-9.

Rey E, Kahn SR, David M, Shrier I. Thrombophilic disorders and fetal loss: a meta-analysis. Lancet. 2003;361(9361):901-8.

Robertson L, Wu O, Langhorne P. Thrombophilia in pregnancy: a systematic review.; thrombosis: risk and economic assessment of thrombophilia screening (TREATS) study. Br J Haematol. 2006;132(2):171-96.

Roque H, Paidas MJ, Funai EF, Kuczynski E, Lockwood CJ. Maternal thrombophilias are not associated with early pregnancy loss. Thromb Haemost. 2004;91:290-5.

Yelnik CM, Laskin CA, Porter TF, Branch DW, Buyon JP, Guerra MM, et al. Lupus anticoagulant is the main predictor of adverse pregnancy outcomes in aPL-positive patients: validation of PROMISSE study results. Lupus Sci Med. 2016;3:e000131.

de Vries JI, Dekker GA, Huijgens PC, Jakobs C, Blomberg BM, van Geijn HP. Hyperhomcoysteinaemia and protein S deficiency in complicated pregnancies. Br J Obstet Gynaecol. 1997;104:1248-54.

Downloads

Published

2017-01-31

Issue

Section

Original Research Articles