title: Thrombophilia is common in women with idiopathic pregnancy loss and is associated with late pregnancy wastage.
abstract: OBJECTIVE
  To describe the characteristics of thrombophilia in women with idiopathic pregnancy loss.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Tertiary referral center in a teaching academic hospital.
  
  
  METHODS
  One hundred forty-five patients with repeated pregnancy loss and 145 matched controls.
  
  
  METHODS
  Prospective assessment of thrombophilia in patients and controls.
  
  
  METHODS
  Prevalence of activated protein C (APC) resistance, protein C, protein S, and antithrombin III deficiencies, antiphospholipid antibodies, factor V Leiden, factor II G20210A, and MTHFR C677T mutations.
  
  
  RESULTS
  At least one thrombophilic defect was found in 66% of study group patients compared with 28% in control group patients. Combined thrombophilic defects were documented in 21% of women with pregnancy loss compared with 5.5% of control patients. Late pregnancy wastage occurred more frequently in women with thrombophilia compared with women without thrombophilia (160/429 [37%] vs. 39/162 [24%], respectively). APC resistance was documented in 39% of women with pregnancy loss compared with 3% of the control patients. APC resistance without factor V Leiden mutation was documented in 18% of women with pregnancy loss compared with none of the controls. While factor V Leiden mutation was more common in women with pregnancy loss (25% vs. 7.6%), factor II G20210A and homozygosity for MTHFR C677T contributed to pregnancy loss only in the presence of other thrombophilia.
  
  
  CONCLUSIONS
  Thrombophilia was found in the majority (66%) of women with idiopathic pregnancy loss. APC resistance with or without factor V Leiden mutation is the most common thrombophilic defect, and combined thrombophilia is a frequent finding in women with pregnancy loss. Thrombophilia is associated with increased frequency of late pregnancy wastage.
authors.affiliation: Thrombosis and Hemostasis Unit, Department of Hematology, Rambam Medical Center, Haifa 31096, Israel. g_sarig@rambam.health.gov.il
authors.forename: Galit
authors.initials: G
authors.lastname: Sarig
authors.forename: Johnny S
authors.initials: JS
authors.lastname: Younis
authors.forename: Ron
authors.initials: R
authors.lastname: Hoffman
authors.forename: Naomi
authors.initials: N
authors.lastname: Lanir
authors.forename: Zeev
authors.initials: Z
authors.lastname: Blumenfeld
authors.forename: Benjamin
authors.initials: B
authors.lastname: Brenner
mesh_terms: D000026:Abortion, Habitual / Q000097:blood / Q000209:etiology*; D000328:Adult; D017153:Antibodies, Anticardiolipin / Q000097:blood; D000990:Antithrombin III / Q000032:analysis; D015331:Cohort Studies; D005165:Factor V / Q000032:analysis; D005260:Female; D006801:Humans; D016682:Lupus Coagulation Inhibitor / Q000097:blood; D042965:Methylenetetrahydrofolate Reductase (NADPH2); D000587:Oxidoreductases Acting on CH-NH Group Donors / Q000235:genetics; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D020151:Protein C Deficiency / Q000097:blood; D018455:Protein S Deficiency / Q000097:blood; D011516:Prothrombin / Q000235:genetics; D019851:Thrombophilia / Q000097:blood / Q000150:complications*
chemical_list: D017153:Antibodies, Anticardiolipin; D016682:Lupus Coagulation Inhibitor; C095381:factor V Leiden; D000990:Antithrombin III; D005165:Factor V; D011516:Prothrombin; D000587:Oxidoreductases Acting on CH-NH Group Donors; D042965:Methylenetetrahydrofolate Reductase (NADPH2)