Platelet function in patients with a history of unexplained recurrent miscarriage who subsequently miscarry again

Dempsey, Mark; Flood, Karen; Burke, Naomi; Murray, Aoife; Cotter, Brian; Müllers, Sieglinde; Fletcher, Patricia; Geary, Michael; Kenny, Dermot; Malone, Fergal D.

doi:10.1016/j.ejogrb.2015.02.003

Cited by 9 publications

(9 citation statements)

References 19 publications

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“…Dempsey et al [18] showed that patients with subsequent miscarriages had reduced platelet function. Their study suggests that platelets may be involved in the pathophysiology of miscarriage.…”

Section: Discussionmentioning

confidence: 98%

Association between platelet indices and first trimester miscarriage

Akin

Kasap²,

Yuvacı³

et al. 2016

Blood Coagulation &Amp; Fibrinolysis

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We aimed to measure the effect of several potential risk factors on first trimester miscarriage. A total of 169 cases were included in the present study. Patients were selected from women who had first trimester miscarriage (n = 78) and controls were selected from the women who had given birth at term (> 37 weeks of gestation) to healthy infants (n = 91). Compared with the control group, in the miscarriage group gestational age (8.9 ± 2.8 weeks and 8.1 ± 2.2 weeks, respectively, P = 0.032), mean platelet volume (MPV) (8.8 ± 1 and 9.5 ± 1.1 fl, respectively, P < 0.001), plateletcrit (0.209 ± 0.03% and 0.241 ± 0.05%, respectively, P < 0.001), and platelet/lymphocyte ratio (128 ± 37 and 145 ± 60, respectively, P = 0.027) were significantly higher. Multivariate analysis showed that first trimester miscarriage development ratio was 1.909 times higher when MPV value was over 9.1 fl (P < 0.001); 9.147 times higher when plateletcrit value was over 0.219% (P = 0.022). Receiver operating characteristic analysis was performed to determine diagnostic MPV and plateletcrit values for first trimester miscarriage. MPV value greater than 9.1 fl determined miscarriage with 60% sensitivity and 65% specificity, while plateletcrit value greater than 0.219% determined miscarriage with 64.5% sensitivity and 64.7% specificity. MPV and plateletcrit values were strongly associated with first trimester miscarriage. Platelet indices can be used for prediction of fetal loss.

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Section: Discussionmentioning

confidence: 98%

Association between platelet indices and first trimester miscarriage

Akin

Kasap²,

Yuvacı³

et al. 2016

Blood Coagulation &Amp; Fibrinolysis

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“…Patients of pregnancy loss demonstrate reduced platelet function [ 47 ]. The GP6 plays a critical role in platelet adhesion and activation, and GP6 has a major role in collagen-induced platelet signaling [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

Association between Platelet-Specific Collagen Receptor Glycoprotein 6 Gene Variants, Selected Biomarkers, and Recurrent Pregnancy Loss in Korean Women

Ahn

Kim

et al. 2020

Genes

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This paper investigates whether glycoprotein 6 (GP6) gene polymorphisms are a risk factor for recurrent pregnancy loss (RPL) in Korean women. Genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism and real-time polymerase chain reaction amplification. We identified five polymorphisms in the GP6 gene: rs1654410 T>C, rs1671153 T>G, rs1654419 G>A, rs12610286 A>G, and rs1654431 G>A. GP6 rs1654410 CC was associated with decreased RPL risk (adjusted odds ratio = 0.292, 95% confidence interval = 0.105–0.815, p = 0.019), and recessive genotypes were also significantly associated with decreased RPL risk (adjusted odds ratio = 0.348, 95% confidence interval = 0.128−0.944, p = 0.038). GP6 rs1654419 GA was associated with decreased RPL risk (adjusted odds ratio = 0.607, 95% confidence interval = 0.375-0.982, p = 0.042), and dominant genotypes were significantly associated with decreased RPL risk (adjusted odds ratio = 0.563, 95% confidence interval = 0.358−0.885, p = 0.013). Altogether, the genotype frequencies of GP6 rs1654410 T>C and GP6 rs1654419 G>A were significantly different between RPL patients and control participants. Therefore, although GP6 polymorphisms may be useful as biomarkers of RPL, additional studies with heterogeneous cohorts are required to better understand the influence of GP6 and assess its performance as a biomarker.

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“…Platelet aggregation was analyzed with a modification of light transmission aggregometry, after induction by AA, ADP, COL and TRAP. In women with unexplained RPL, in whom pregnancy ended in a new miscarriage, there was a significant reduction in platelet aggregation in response to ADP and TRAP, but not to AA or COL (Dempsey et al, 2015).…”

Section: Recurrent Pregnancy Lossmentioning

confidence: 91%

“…Impaired platelet aggregation has been suggested to play an important role in placenta-mediated obstetric complications, such as RPL, preeclampsia, intrauterine growth retardation, impaired placental circulation and pregnancy-induced hypertension (Morrison et al, 1985;Dogan Gun et al, 2006;Bujold et al, 2009;Flood et al, 2010;Sultana et al, 2012;Dempsey et al, 2015;Atallah et al, 2017). The role of platelet aggregation in unexplained recurrent miscarriage is unclear.…”

Section: Platelet Aggregation and Hemostasismentioning

confidence: 99%

“…ASA, low-molecular-weight heparin (LMWH), intravenous immunoglobulin (IVIG), corticosteroids, lipid emulsion and leucocyte immunization have all been tried. There is no conclusive evidence that any currently available specific medical intervention is successful in decreasing the risk of miscarriage in women with unexplained RPL (Dempsey et al, 2015;Rasmark Roepke et al, 2018).…”

Section: Suggested Treatments For Unexplained Recurrent Pregnancy Lossmentioning

confidence: 99%

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Platelet aggregation in healthy women during normal pregnancy - a longitudinal study

et al. 2018

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Increased platelet activation is involved in obstetric complications such as preeclampsia and intrauterine growth retardation. It is of interest to study platelet aggregation during pregnancy, since increased aggregation theoretically could be a mechanism associated with placenta-mediated complications, which possibly could be prevented by drugs inhibiting platelet aggregation. There are, however, few robust studies describing platelet aggregation during normal pregnancy. The present longitudinal study was performed in order to study platelet aggregation during normal pregnancy resulting in a healthy child, during the puerperium and in nonpregnant, fertile women. Healthy, nonsmoking, pregnant women (n = 104), aged under 39 years and with BMI < 35, were followed during pregnancy and postpartum. Twenty-seven nonpregnant, non-puerperal, fertile women were studied for comparison. Platelet aggregation was determined with multiple electrode impedance aggregometry and analyzed at inclusion, 4 times during pregnancy and after at least 3 months postpartum. Platelet aggregation postpartum was compared with gestational weeks 8-15 and 37-40, respectively, and with nonpregnant, fertile women. Hemoglobin, leucocyte count, platelet count, prothrombin time, and activated partial thromboplastin time were determined at inclusion in order to verify normal hemostasis. Activation of platelets by arachidonic acid, adenosine diphosphate (ADP), and thrombin receptor activating peptide (trap-6) resulted in less aggregation during pregnancy, compared with postpartum (p < 0.03-< 0.001). Platelet aggregation following activation by collagen was unchanged. A minor increase in aggregation as pregnancy continued was found related to ADP (p < 0.021). Positive correlations were found between platelet counts and platelet aggregation. Postpartum platelet aggregation after activation with arachidonic acid, collagen, and trap-6 was lower than in the non-puerperal fertile state. Other hemostatic analyses were normal. In conclusion, there is a minor decrease in platelet aggregation after activation with arachidonic acid, trap-6, and ADP, measured with multiple electrode impedance aggregometry during normal pregnancy resulting in healthy babies, compared with the postpartum period. The small changes in platelet aggregation may be a consequence of a minor decrease in platelet count and probably lack clinical significance under normal conditions. Interindividual variations at certain time-points are substantial, which limits the usefulness of the multiple electrode impedance aggregometry for determining minor changes in platelet function.

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Platelet function in patients with a history of unexplained recurrent miscarriage who subsequently miscarry again

Cited by 9 publications

References 19 publications

Association between platelet indices and first trimester miscarriage

Association between platelet indices and first trimester miscarriage

Association between Platelet-Specific Collagen Receptor Glycoprotein 6 Gene Variants, Selected Biomarkers, and Recurrent Pregnancy Loss in Korean Women

Platelet aggregation in healthy women during normal pregnancy - a longitudinal study

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