Coagulation factor deficiency as a cause of recurrent fetal loss: a red herring!
Whether severe coagulation factor deficiency can cause adverse pregnancy outcomes or recurrent fetal loss is not definitely known. We report here on five women with severe deficiency of coagulation factors (two factor X, one factor XI, one factor VII and one von Willebrand factor) who presented with history of unexplained fetal loss or with adverse pregnancy outcome. Detailed investigations of thrombophilia showed that four patients were positive for antiphospholipid antibodies, one of whom was also homozygous for the plasminogen-activator inhibitor-1 4G/4G polymorphism, and the fifth patient was deficient for protein C. Despite the concomitant presence of both coagulation factor defect and thrombophilia, fetal loss may be attributed to factor defect that in reality is a red herring, with underlying thrombophilia not being evaluated.
Vora
Sonal
S
Institute of Immunohaematology (ICMR), KEM Hospital, Parel, Mumbai, India.
Shetty
Shrimati
S
Ghosh
Kanjaksha
K
D000026:Abortion, Habitual / Q000097:blood / Q000276:immunology*; D000328:Adult; D017304:Annexin A5 / Q000276:immunology; D017153:Antibodies, Anticardiolipin / Q000097:blood*; D017152:Antibodies, Antiphospholipid / Q000097:blood*; D020147:Coagulation Protein Disorders / Q000150:complications / Q000175:diagnosis / Q000276:immunology*; D005260:Female; D006801:Humans; D017395:Plasminogen Activator Inhibitor 1 / Q000235:genetics; D011247:Pregnancy; D020151:Protein C Deficiency / Q000150:complications / Q000175:diagnosis
D017304:Annexin A5; D017153:Antibodies, Anticardiolipin; D017152:Antibodies, Antiphospholipid; D017395:Plasminogen Activator Inhibitor 1