Thrombophilia is common in women with idiopathic pregnancy loss and is associated with late pregnancy wastage.
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.
Sarig
Galit
G
Thrombosis and Hemostasis Unit, Department of Hematology, Rambam Medical Center, Haifa 31096, Israel. g_sarig@rambam.health.gov.il
Younis
Johnny S
JS
Hoffman
Ron
R
Lanir
Naomi
N
Blumenfeld
Zeev
Z
Brenner
Benjamin
B
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*
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)