title: The prevalence of lupus anticoagulant in normal pregnancy and in women with recurrent fetal loss--recommendations for laboratory testing for lupus anticoagulant.
abstract: BACKGROUND
  There is wide disagreement in the literature on the rate of detection of lupus anticoagulant (LA) in women with recurrent fetal loss (RFL). The aim of this study was to determine the prevalence of LA using four phospholipid-dependant coagulation tests in a large population of Saudi women.
  
  
  METHODS
  We determined the prevalence of LA in women with RFL (n=925), normal pregnancy (n=663), and in healthy blood donors (n=204), at the King Khalid University Hospital, Riyadh. The following coagulation tests were employed: the activated partial thromboplastin time (APTT), platelet neutralization procedure (PNP), kaolin clotting time (KCT) and the dilute Russel's viper venom test (dRVVT).
  
  
  RESULTS
  In RFL patients, positive APTT was 10.2%, APTT+PNP 3.6%, KCT 10.5%, and dRVVT 10.9%. In normal pregnancy, the corresponding figures were 12.8%, 3.1%, 10.8%, and 5.6%. Three positive tests occurred in 2.3% of RFL patients, including APTT+KCT 3.5%, APTT+dRVVT 3.9%, and KCT+dRWT 4.1%. The corresponding figures for normal pregnancy were 1.6% for three positive tests, and 3.0%, 1.8%, 2.4%, respectively. The dRVVT was the only test that showed a rate of positive results almost double that seen in normal pregnancy.
  
  
  CONCLUSIONS
  If only one or even two screening tests were performed, a significant number of LA positive cases would have been missed. This could make a difference to treating physicians as to the possible etiology and management of RFL. It is therefore advisable to routinely use the three tests (APTT, KCT and dRRVT) when screening for LA.
authors.affiliation: Department of Obstetrics of Gynecology, College of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia.
authors.forename: Abdul Aziz A
authors.initials: AA
authors.lastname: Al-Mishari
authors.forename: Abdel Galil M Abdel
authors.initials: AG
authors.lastname: Gader
authors.forename: Abdul Wahab
authors.initials: AW
authors.lastname: Al-Jabbari
authors.forename: Abdul Karim M
authors.initials: AK
authors.lastname: Al-Momen
authors.forename: Mohamed O Gad
authors.initials: MO
authors.lastname: El Rab
authors.forename: Zainab H
authors.initials: ZH
authors.lastname: Babay
authors.forename: Nasim
authors.initials: N
authors.lastname: Mahmoud
mesh_terms: D000026:Abortion, Habitual / Q000276:immunology*; D005260:Female; D006801:Humans; D016682:Lupus Coagulation Inhibitor / Q000097:blood*; D011247:Pregnancy; D015995:Prevalence; D012529:Saudi Arabia / Q000453:epidemiology
chemical_list: D016682:Lupus Coagulation Inhibitor