Predictive value of thrombopath determination in women with infertility and pregnancy complications.
BACKGROUND
A condition of maternal thrombophilia, either inherited or acquired, can compromise the success of implantation and foetal survival.


METHODS
Malfunctions in protein C pathway were evaluated using a novel assay [HemosIL ThromboPath (ThP)] in a case-control study of 172 women with a history of recurrent miscarriage or infertility and 86 age-matched unrelated fertile women.


RESULTS
Thrombophilia was ascertained in 13% of the cases. ThP values were lower in women either with or without thrombophilia compared to controls (both p<0.0001). Abnormal ThP values (below the mean minus 1SD of controls) were found in 62% of cases compared to 12% of controls (p<0.0001). Non-thrombophilic women who achieved spontaneous pregnancy had higher ThP values compared to those who did not (p<0.05). Elevated ThP values were an independent predictor for pregnancy (p<0.01) in women without thrombophilia. A decrease of ThP values was observed during pregnancy progression, which correlated with that of protein S (p<0.05). Miscarriage or major complications occurred in women in whom ThP percent change was approximately 2-fold higher than that observed in women who achieved successful pregnancy (p<0.05).


CONCLUSIONS
ThP might represent an efficient assay for screening women with pregnancy complications and might provide prognostic information during pregnancy progression.
Ferroni
Patrizia
P
Dept. of Laboratory Medicine & Advanced Biotechnologies, IRCCS San Raffaele Pisana, 00163, Rome, Italy. patrizia.ferroni@sanraffaele.it
La Farina
Francesca
F
Palmirotta
Raffaele
R
Martini
Francesca
F
Raparelli
Valeria
V
Nigro
Carmen
C
Riondino
Silvia
S
Rampini
Maria Rita
MR
Basili
Stefania
S
Guadagni
Fiorella
F
D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000097:blood*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood*; D019851:Thrombophilia / Q000150:complications*