IS TODAY'S THROMBOPHILIA PROFILE ADEQUATE IN IDENTIFYING A POSSIBLE CAUSE FOR RECURRENT FETAL LOSS IN WOMEN?

Abstract number: P-W-467

Thiruchelvam¹ A., Sawiah² S., Sekaran¹ M., Ayob³ Y.

¹¹Molecular Medicine ²²Obstetrics & Gynaecology, University Malaya ³³Blood Transfusion, National Blood Centre, Kuala Lumpur, Malaysia

How-to-cite Thiruchelvam A, Sawiah S, Sekaran M, Ayob Y. IS TODAY'S THROMBOPHILIA PROFILE ADEQUATE IN IDENTIFYING A POSSIBLE CAUSE FOR RECURRENT FETAL LOSS IN WOMEN?. J Thromb Haemost 2007; 5 Supplement 2: P-W-467

Abstract

Introduction: Recurrent Fetal Loss (RFL) is a woman's nightmare - more so if she is from an Asian background. Abnormal thrombophilia profile (TP) has been implicated in RFL. The routine TP consist of tests for lupus anticoagulant, anticardiolipin antibodies, protein C pathway abnormalities, protein C/S deficiencies and factor V Leiden & prothrombin G20210A mutations. However, recent developments in thrombophilia have implicated newer markers as possible causes for RFL. They are anti-b2-glycoprotein I, anti-prothrombin, anti-annexin-V, MTHFR-C677T mutation and hyper-homocysteinemia. Is the present TP adequate to identify a cause for RFL?

Methods: 302 Malaysian women from the 3 main ethnic races of Malays, Chinese and Indians were investigated for thrombophilia abnormalities. Their ages ranged from 18-40 years. They were excluded for chromosomal abnormalities, hormonal imbalances and anatomical pathology. LA and anticardiolipin antibodies were screened using phospholipid-based clotting tests and ELSA methods respectively. Protein C resistance tests excluded abnormalities in the PC pathway. Real-Time Polymerase-chain reaction confirmed factor V Leiden and prothrombin G20210A mutations.

Results: 75 (25%) patients from a total of 302 showed one or more abnormalities in the routine TP. The remaining 227 (75%) patients showed a normal TP.

Table:

Malaysian Race:	Patients with RFL	Normal TP	Abnormal TP
Malays	211	158 (75%)	53 (25%)
Chinese	24	20 (83%)	4 (17%)
Indians	67	49 (73%)	18 (27%)
TOTAL	302	227 (75%)	75 (25%)

Conclusions: What is then the possible explanation for RFL in 75% of the patients with a normal TP? All other pathology, with the exception of the newer thrombophilia markers, have been ruled out. The above finding thus challenges the adequacy of the current routine TP. The TP should now be supplemented with the newer thrombophilia markers to ensure a wider scope in identifying a cause for RFL.

To cite this abstract use the following format:

Journal of Thrombosis and Haemostasis 2007; Volume 5, Supplement 2: abstract number

Session Details

Date:	01/08/2007
Time:	00:00-00:00
Session name:	XXIst ISTH Congress
Subject:
Location:	Oxford, UK
Presentation type:
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