A comparative study of the serum levels of antiphospholipid antibodies in hypertensive disorder of pregnancy and normotensive pregnancy
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20170386Keywords:
Antiphospholipid antibodies, Aeskulsia phospholipid-screen-GM, Hypertensive disorder in pregnancyAbstract
Background: Antiphospholipid antibodies have been associated with a number of obstetric complications however their role in the pathogenesis of preeclampsia has remained uncertain Therefore, the utility of screening for antiphospholipid antibodies among women at risk for recurrent hypertensive disorder of pregnancy is still doubtful. This study is aimed to clarify relationship between hypertensive pregnancies and APLA.
Methods: A prospective, randomized was conducted and, 120 patients after 20 weeks of gestation were studied. 60 patients had hypertensive disorder in pregnancy and 60 were normotensive. Blood samples were obtained from them under all asepsis, serum was separated and tested for Antiphospholipid antibodies (Anticardiolipin, anti beta 2 glycoprotein I, phosphatidyl -serine, -inositol, -ethanolamin, -choline and sphingomyelin and lupus anticoagulant), apart from other routine investigations using Aeskulsia Phospholipid-Screen-GM.
Results: 4/60 and 3/60 hypertensive patients had raised IgM and IgG levels respectively. Their values came in equivocal range. 2 of the normotensive patients had equivocal range values of both IgM/IgG. Mean of IgM APLA in hypertensive and normotensive patients was 2.54 and 1.67 respectively and difference between these values was statistically non significant (p=0.081). Mean of APTT is similarly statistically non significant in two groups (p=0.817).
Conclusions: No significant correlation between the hypertensive state in pregnancy and antiphospholipid antibodies, hence this test should not be recommended as a screening test in pregnancies and there was no need to assess these antibodies in the hypertensive cases of pregnancy without the history of thrombosis or autoimmune diseases.References
Vormittag R, Pabinger I. Thrombophilia and pregnancy complications. Hamostaseologie. 2006;26(1):59-62.
Harris EN. Antiphospholipid antibodies. Br J Haematol. 199;74(1):1-9.
Feinstein DI. Lupus anticoagulant, anticardiolipin antibodies, fetal loss, and systemic lupus erythematosus. Blood. 1992;80:859-62.
Hugues GRV. The antiphospholipid syndrome: Ten years on. The Lancet. 1993;342:341-3.
Triplett DA. Antiphospholipid antibodies and recurrent pregnancy loss. Am J Reprod Immunol. 1989;20:52-67.
Ginsberg JS, Demers C, Brill-Edwards P, Johnston M, Bona R, Burrows RF, et al. Increased thrombin generation and activity in patients with systemic lupus erythematosus and anticardiolipin antibodies: Evidence for a prothrombotic state. Blood, 1993;81:2958-63.
Santoro SA. Antiphospholipid antibodies and thrombotic predisposition: Underlying pathogenetic mechanisms. Blood. 1994;83:2389-91.
Ermel LD, Marshbum PB, Kutteh WH. Interaction of heparin with antiphospholipid antibodies from the sera of women with recurrent pregnancy loss. Am J Repro Immuno. 1995;33:14-20.
Milliez J, Lelong F, Bayani N, Janet D, Medjadji, Latrous H, et al. The prevalence of autoantibodies during third trimester pregnancy complicated by hypertension or idiopathic fetal growth retardation. Am J Obst Gynecol. 1991;165:51-6.
Pattison NS, Chamley LW, McKay EJ, Liggins GC, Butler WS. Antiphospholipid antibodies in pregnancy: Prevalence and clinical associations. Br J Obstet Gynecol. 1993;100:909-13.
Yasuda M, Takakuwa K, Tokunaga A, Tanaka K. Prospective studies of the association between anticardiolipin antibody and outcome of pregnancy. Obstet Gynecol. 1995;86:555-9.
Out HJ, Bruinse HW, Christiaens GC, van Vliet M, de Groot PG, Nieuwenhuis HK, et al. A prospective, controlled multicenter study on the obstetric risks of pregnant women with antiphospholipid antibodies. Am J Obstet Gynecol. 1992;167:26-32.
Matthiesen LS, Berg G, Ernerudh J, Skogh T. A prospective study on the occurrence of autoantibodies in low-risk pregnancies. Eur J Obstet Gynecol Reprod Biol. 1999;83:21-6.
Dreyfus M, Hedelin G, Kutnahorsky R, Lehmann M, Viville B, Langer B, et al. Antiphospholipid antibodies and preeclampsia: a case-control study. Obstet Gynecol. 2001;97(1):29-34.
Lockshin MD. Antiphospholipid antibody syndrome. Rheum Dis Clin North Am. 1994;20:45-59.
Vahid F, Ayatiy S, Shakeri M.T. Comparison of Antiphospholipid Antibodies between Preeclampsia and Normal Pregnant Women. Iran J Med Sci. 2006;31(1):47-9.
Moodley J, Bhoola V, Duursma J, Pudifin D, Byrne S, Kenoyer DG. The association of antiphospholipid antibodies with severe early-onset pre-eclampsia. S Afr Med J. 1995;85:105-7.
Van Pampus MG, Dekker GA, Wolf H, Huijgens PC, Koopman MM, von Blomberg BM, et al. High prevalence of hemostatic abnormalities in women with a history of severe preeclampsia. Am J Obstet Gynecol. 1999;180:1146-50.
Rao AA, Ananthakrishna NC. Anticardiolipin antibodies in eclampsia. Int J Gynaecol. Obstet. 1992;38:37-40.
Martínez-Abundis E, González-Ortiz M, Cortés-Llamas V, Salazar-Páramo M. Anticardiolipin antibodies and the severity of preeclampsia-eclampsia. Gynecol Obstet. Invest. 1999;48:168-71.
Branch DW, Porter TF, Rittenhouse L, Caritis S, Sibai B, Hogg B, et al. Antiphospholipid antibodies in women at risk for preeclampsia. Am J Obstet Gynecol. 2001;184:825–34.
Salehi R, Asl AA, Alizadeh M, Sayyahmelli M, Azarfarin. Comparison of Antiphospholipid Antibodies in Hypertensive with Normotensive Pregnant Women. RMJ. 2007;32(2):173-5.
Açmaz G, Tayyar A, Öner G, Tayyar M. The investigation of relationship between preeclampsia and antiphospholipid antibody syndrome. Cumhuriyet Med J. 2013;35:83-88.
Sajith M, Nimbargi V, Modi A, Sumariya R, Pawar A. Incidence of pregnancy induced hypertension and prescription pattern of antihypertensive drugs in pregnancy. International Journal of Pharma Sciences and Research. 2014;5(4):163-174.
Gudnadottir TA, Bateman BT, Hernadez-Diaz S, Luque-Fernandez MA, Valdmarsdottir U, Zoega H. Body mass index, smoking and hypertensive disorders during Pregnancy: A population based case control study. 2016;11:e0152187.
Hazari NR, Hatolkar VS, Munde SM. Study of Serum Hepatic Enzymes in Preeclampsia. International Journal of Current Medical and Applied Sciences. 2014;1(2):1-8.
Wang IK. Association between hypertensive disorders during pregnancy and end stage renal disease: A population based study. 2013;185(3):207-13.
Rahim R, Nahar K, Khan IA. Platelet count in 100 cases of pregnancy induced hypertension. Mymensingh Med J. 2010;19(1):5-9.