Increased fetal loss in women with heritable thrombophilia

Preston, F. E.; Fr, Rosendaal; Walker, I. D.; Briët, E.; Berntorp, Erik; Conard, J.; Fontcuberta, Jordi; Makris, Mike; Mariani, Guglielmo; Noteboom, William D.; Pabinger, Ingrid; Legnani, Cristina; Scharrer, I.; Schulman, Sam; Meer, Fjm van der

doi:10.1016/s0140-6736(96)04125-6

Cited by 641 publications

(412 citation statements)

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“…Insofar as thrombosis was implicated with recurrent idiopathic miscarriages and later pregnancy com- plications [25][26][27][28][29], we investigated the association of FV Leiden and PRT G20210A mutations, together with APC resistance, in women with pregnancy loss where routine investigations could not pinpoint an exact cause. Patients and controls were matched for a number of factors, including age, smoking, and use of oral contraceptives, and it was clear that patients with recurrent idiopathic miscarriages had a higher prevalence of hereditary thrombophilia (FV Leiden but not PRT G20210A) than did control parous women.…”

Section: Discussionmentioning

confidence: 99%

Association between adverse pregnancy outcomes and maternal factor V G1691A (Leiden) and prothrombin G20210A genotypes in women with a history of recurrent idiopathic miscarriages

et al. 2005

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Thrombophilia was implicated in the development of pregnancy complications, including recurrent idiopathic pregnancy loss, and is aggravated in women who are carriers of factor V G1691A (FV Leiden) and prothrombin (PRT) G20210A single-nucleotide polymorphisms (SNPs). Previous studies examined the role of FV-Leiden and PRT G20210A in recurrent pregnancy loss with conflicting results. Here we examined the prevalence of FV Leiden and PRT G20210A SNPs, in 200 women with 3 or more consecutive early (n = 87), late (n = 41), or early-late (n = 72) recurrent pregnancy losses, and 200 age-matched fertile parous control women. APC resistance (APCR) was detected functionally (measuring the activated clotting time triggered by activated factor X in presence of a fixed amount of purified APC), and FV-Leiden and PRT G20210A genotypes were assessed by PCR. The frequency of the mutant FV (0.1400 vs. 0.0276; P < 0.001) but not PRT 20210 (0.0100 vs. 0.0225; P = 0.159) allele was higher in patients than controls, respectively. APC resistance with factor V Leiden was seen in 27% of patients compared to 11.5% of controls, while APC resistance without factor V Leiden was seen in 12.5% of patients compared to 9.5% of controls. Regression analysis demonstrated that the significant predictors for early abortion was FV Leiden; those for late abortion were oral contraceptive, APCR, and FV Leiden; and predictors for early-late abortions were oral contraceptives, obesity, FV Leiden, and smoking. APC resistance and FV Leiden, as well as combination of both, are common thrombotic defects seen in women with idiopathic recurrent pregnancy loss, thus testing for these is recommended in women who have experienced recurrent miscarriages. Am.

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Section: Discussionmentioning

confidence: 99%

Association between adverse pregnancy outcomes and maternal factor V G1691A (Leiden) and prothrombin G20210A genotypes in women with a history of recurrent idiopathic miscarriages

et al. 2005

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“…Only recently, these factors have been related to uteroplacental insufficiency. Thrombophilic defects, notably deficiencies of anticoagulant factors, were found in up to 50% of patients with severe pre-eclampsia and HELLP syndrome [3] and they have been associated with an increased risk of stillbirth as well as foetal growth retardation [15,16].…”

Section: Introductionmentioning

confidence: 99%

Factor VIII levels and the risk of pre-eclampsia, HELLP syndrome, pregnancy related hypertension and severe intrauterine growth retardation

Witsenburg

Rosendaal

Middeldorp

et al. 2005

Thrombosis Research

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Objective: Recently, acquired as well as genetic prothrombotic factors are associated with thrombotic events. These factors have also been related to conditions of uteroplacental insufficiency such as pre-eclampsia, HELLP syndrome and severe intrauterine growth restriction (IUGR). The aim of this study was to determine whether elevated factor VIII levels are associated with uteroplacental insufficiency, in particular pre-eclampsia, HELLP syndrome or pregnancy-induced hypertension and intrauterine growth retardation. Methods: Plasma samples of 75 women with a history of pregnancy complicated by pre-eclampsia, HELLP syndrome, pregnancy induced hypertension or intrauterine growth restriction were tested for factor VIII:C (FVIII:C) levels at a minimum of 10 weeks post-partum. Laboratory results were compared to factor VIII:C levels found in a healthy control group of 272 women. Results: Mean factor VIII:C levels were similar at 123 IU/dl in both the patient group and the controls. In a logistic regression model, after adjusting for age and blood group, no effect of factor VIII:C levels on the risk of pregnancy complications was observed, with the exception of IUGR with (OR 2.9, CI 1.0-8.7) or without hypertension (OR 2.0, CI 0.7-6.4). Conclusion: If the elevated level of factor VIII would be the sole factor responsible for the increased risk observed, one would expect to find an effect of blood group on 0049-3848/$ -see front matter D

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“…2 -10 As much as 65% of those vascular complications may be associated with some form of inherited or acquired thrombophilia. 11,12 In previous studies, 80% of the carriers of a thrombophilic genetic defect who experienced 'unexplained' fetal death demonstrated placental thrombosis, infarctions and extensive perivillous fibrin deposition. 10 In pre-eclampsia, paternal as well as maternal genes, expressed in the fetus and the trophoblast, may play a part.…”

Section: Introductionmentioning

confidence: 99%

Maternal and Paternal Thrombophilia: Risk Factors for Perinatal Mortality

&NA;

2005

Obstetric Anesthesia Digest

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Increased fetal loss in women with heritable thrombophilia

Cited by 641 publications

References 10 publications

Association between adverse pregnancy outcomes and maternal factor V G1691A (Leiden) and prothrombin G20210A genotypes in women with a history of recurrent idiopathic miscarriages

Association between adverse pregnancy outcomes and maternal factor V G1691A (Leiden) and prothrombin G20210A genotypes in women with a history of recurrent idiopathic miscarriages

Factor VIII levels and the risk of pre-eclampsia, HELLP syndrome, pregnancy related hypertension and severe intrauterine growth retardation

Maternal and Paternal Thrombophilia: Risk Factors for Perinatal Mortality

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