title: Etiology of hypercoagulable state in women with recurrent fetal loss without other causes of miscarriage from Southern Italy: new clinical target for antithrombotic therapy.
abstract: BACKGROUND
  Recurrent fetal loss (RPL) is one of the most common cause of sterility. Several studies identified thrombophilia as the principal cause of recurrent pregnancy loss. However, reported studies often do not evaluate other causes of miscarriages in their inclusion and exclusion criteria. So the aim of our study was to investigate the role of inherited thrombophilia in patients with RPL and without other causes of RPL.
  
  
  METHODS
  Patients with 2 or more first trimester abortion or with 1 or more late pregnancy loss were considered for this study. In order to evaluate the causes of RPL we looked for chromosomal, endocrine, chronic inflammatory, and infectious alterations. 90 patients affected by unexplained RPL were enrolled and tested for hemostatic alterations. These women were tested for inherited and/or acquired thrombophilia by MTHFR C677T gene polymorphism, factor V Leiden gene polymorphism, PTHRA20210G gene polymorphism, protein S deficiency, protein C deficiency, antithrombin III deficiency, lupus anticoagulant, and anticardiolipin antibodies Ig G and Ig M.
  
  
  RESULTS
  Acquired and/or inherited thrombophilia are strongly associated with RPL when other common causes of miscarriage were excluded. 78% of tested women showed hemostatic abnormalities. Several women with combined thrombophilic defects were also identified by our data.
  
  
  CONCLUSIONS
  After a thorough evaluation of other causes of miscarriage women affected by RPL should be tested for thrombophilia. Our data demonstrated 78% of women with one or combined thrombophilic conditions. Differences with previous studies should be related to difference in the inclusion and exclusion criteria and ethnic background. Because these patients often also show a hypercoagulable state, it an antithrombotic treatment before and during pregnancy may improve their clinical outcome (ie, secondary prevention of miscarriage and primary thromboprophylaxis).
authors.affiliation: Dipartimento Universitario di Scienze Ostetriche Ginecologiche e Medicina della Riproduzione, Area Funzionale di Medicina della Riproduzione ed Endoscopia Ginecologica, Università degli Studi di Napoli Federico II, via Pansini 5 Building 9, 80131, Naples, Italy.
authors.forename: Maristella
authors.initials: M
authors.lastname: D'Uva
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Di Micco
authors.forename: Ida
authors.initials: I
authors.lastname: Strina
authors.forename: Antonio
authors.initials: A
authors.lastname: Ranieri
authors.forename: Carlo
authors.initials: C
authors.lastname: Alviggi
authors.forename: Antonio
authors.initials: A
authors.lastname: Mollo
authors.forename: Francesca
authors.initials: F
authors.lastname: Fabozzi
authors.forename: Lucia
authors.initials: L
authors.lastname: Cacciapuoti
authors.forename: Maria Teresa Scotto
authors.initials: MT
authors.lastname: di Frega
authors.forename: Mariateresa
authors.initials: M
authors.lastname: Iannuzzo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Placido
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