Increased resistance to activated protein C and factor V Leiden in recurrent abortions. Review of other hypercoagulability factors.
OBJECTIVE
To evaluate hereditary and acquired hemostatic abnormalities associated with recurrent spontaneous early (first-trimester) abortions.


METHODS
A group of 56 Greek women with two or more unexplained primary spontaneous abortions, and a reference group of 148 women without a history of recurrent abortions, were screened for hypercoagulability. A randomly selected population of first-trimester pregnant women was also chosen for factor V Leiden genetic screening.


RESULTS
A total of 21% of the women with recurrent abortions, compared with 12% of the reference group, showed increased activated protein C resistance. Fourteen per cent had positive lupus anticoagulant, compared with 11.5% of the reference group. For the rest of the parameters, there was no difference between the two groups. Of 22 women studied for factor V Leiden, one was homozygous and one was heterozygous. Results were compared using Fisher's exact test and two-tailed Student's t tests.


CONCLUSIONS
Increased activated protein C resistance appears to be an important factor in women with recurrent abortions. These data indicate the need for routine investigation of activated protein C resistance in women with recurrent abortions.
Hatzis
T
T
Department of Hematology, Mitera Maternity and Surgical Center, Athens, Greece.
Cardamakis
E
E
Drivalas
E
E
Makatsoris
K
K
Bevan
D
D
Pantos
C
C
Malliopoulou
V
V
Tsagaris
N
N
Kreatsa
O
O
Antoniadi
T
T
Petersen
M B
MB
Karageorgiou
H
H
Mantouvalos
H
H
D000022:Abortion, Spontaneous / Q000097:blood / Q000453:epidemiology / Q000235:genetics*; D005165:Factor V / Q000235:genetics*; D005260:Female; D005820:Genetic Testing; D006801:Humans; D009154:Mutation; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011336:Probability; D011486:Protein C / Q000235:genetics*; D012008:Recurrence; D012016:Reference Values; D018570:Risk Assessment; D019851:Thrombophilia / Q000235:genetics*
D011486:Protein C; C095381:factor V Leiden; D005165:Factor V