Gestational vascular complications: screening for congenital thrombophilia?
Abstract number: PP-WE-374
Morais1 S., Laranjeira1 C., Faria1 S., Lima1 L., Lopes1 R., Pereira1 M., Moreira1 L., Oliveira1 F., Valente1 E., Cunha2 A., Braga2 J., Campos1 M.
11Haematology 22Obstetric, Centro Hospitalar Porto, Porto, Portugal
How-to-cite Morais S, Laranjeira C, Faria S, Lima L, Lopes R, Pereira M, Moreira L, Oliveira F, Valente E, Cunha A, Braga J, Campos M. Gestational vascular complications: screening for congenital thrombophilia?. Journal of Thrombosis and Haemostasis 2009; Volume 7, Supplement 2: Abstract PP-WE-374
Introduction: Vascular gestational complications are a well-known complication of antiphospholipid syndrome, an acquired thrombophilia. Recently, genetic thrombophilia was also claimed to be an important risk factor for obstetrical complications. Our previous screening for thrombophilia in 69 women, do not confirm this finding, so we continued to evaluate the presence of genetic or acquired thrombophilia, in women with gestational vascular complications.
Material and Methods: A total of 134 women with obstetric complications such as 1st trimester recurrent fetal loss (69), 2nd and 3rd trimester fetal loss (35) and severe pre-eclampsia/HELLP syndrome (30) were studied. Women with a previous thromboembolic event were excluded. These patients were tested for the presence of Factor V Leiden, Prothrombin 20210 G > A, and for alterations in the circulating levels of Protein C, Protein S, Antithrombin, ACA-IgG, ACA-IgM, ß2GPI-IgG, ß2GPI-IgM and Lupus Anticoagulant.
Results: Anti-phospholipid antibodies were found in 14 patients (10.4%), seven of them suffering from 1st trimester recurrent fetal loss, three from 2nd–3rd trimester fetal loss and the remainder four from severe pre-eclampsia/HELLP syndrome. Only one woman (< 1%) had AT deficiency and another had protein S deficiency. Heterozygote Factor V Leiden mutation was found in 5.9% of cases, and heterozygote Prothrombin 20210 G > A in 3.7% (no homozygotes were found).
Conclusion: Out of the anti-phospholipid antibodies, we continued not find significant trombophilic risk factors in women with obstetric complications. The frequency of the above mentioned mutations was similar to the frequency found on our control population (6.1% for Factor VL, and 2.2% for Prothrombin 20210 G > A). Larger studies are needed in order to confirm the genetic thrombophilia as a risk factor in obstetric vascular complications, and the cost-effectiveness of such screening.
Disclosure of interest: none declared.