[High risk of recurrent spontaneous abortion during second trimester in women carriers of polymorphism A2 in platelet glycoprotein IIb/IIIa].
The aim of this study was to evaluate the role of polymorphism A2 (PLA2) in platelet glycoprotein IIb/IIIa (GP IIb/IIIa) in the development of recurrent spontaneous abortion (RSA)--miscarriages before 20th week of gestation (wg) of pregnancy. The carriage status of PLA2 in GP IIb/IIIa, single and in combination with FVL and FII G20210A was investigated in 56 women with recurrent miscarriages before 10 g, in 38 women with RSA from 10 to 20 wg and in 98 healthy women with at least one uncomplicated full-term pregnancy. The significant prevalence of carriage of PLA2 in GP IIb/IIIa in women with RSA in first 20 wg was found with high risk or miscarriage (OR = 4.32; 95% CI: 2.10-8.97, p < 0.0001). However, after adjustment for combined carriage of other thrombophilic factors (PLA2 and FVL or PLA2 with FII G20210A) the risk was still high (OR = 2.07; 95% CI: 0.98-4.40 p = 0.058), but not significant. The similar results (OR = 2.632; 95% CI: 1.140-6.104, p = 0.021) were found for women with recurrent miscarriages in the first 10 wg. The prevalence of PLA2 adjusted for combined carriage of other thrombophilic factors was also not significant. The carriage status of PLA2 in GP IIb/IIIa in women with RSA in the period from 10 to 20 wg was significantly higher as compared to controls (OR = 8.79; 95% CI: 3.477-22.605, p < 0.0001). The prevalence, adjusted for combined carriage of other thrombophilic factors (PLA2 with FVL or PLA2 with FII G20210A) was also significantly higher (OR: 2.990; 95% CI: 1.178-7.613, p = 0.018). These results confirm the impact of PLA2 polymorphism on RSA in the period of 10 to 20 wg, and its contribution to RSA in the first 10 wg in combination with other thrombophilic mutations. The results support the suggestion of testing women with miscarriages in first 20 wg for PLA2 carriage and application of appropriate prophylactic antiplatelet drug therapy for next planned pregnancy.
Ivanov
P
P
Komsa-Penkova
R
R
Ivanov
I
I
Konova
E
E
Kovacheva
K
K
Stoĭkov
S
S
Popov
I
I
D000026:Abortion, Habitual / Q000097:blood / Q000235:genetics*; D000328:Adult; D016022:Case-Control Studies; D004247:DNA / Q000235:genetics; D005165:Factor V / Q000235:genetics; D005260:Female; D005865:Gestational Age; D006801:Humans; D039661:Integrin beta3 / Q000235:genetics*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000235:genetics*; D020641:Polymorphism, Single Nucleotide; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012306:Risk
D039661:Integrin beta3; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; C095381:factor V Leiden; D005165:Factor V; D004247:DNA