title: Coagulation inhibitors and activated protein C resistance in recurrent pregnancy losses in Indian women.
abstract: BACKGROUND
  Thrombophilias, both acquired and inherited, have been investigated in the etiopathogenesis of unexplained recurrent pregnancy loss.
  
  
  OBJECTIVE
  To study coagulation inhibitors and activated protein C resistance (APCR) in recurrent pregnancy losses (RPL) occurring in second and third trimesters.
  
  
  METHODS
  A total of 30 pregnant women (group A) with two or more recurrent unexplained fetal loses were evaluated for APCR, protein C deficiency, protein S deficiency, antithrombin deficiency, and antiphospholipid antibodies (APLA). Thirty age-matched controls were taken (group B) comprising of pregnant women with at least one live issue.
  
  
  METHODS
  Comparisons between two group frequencies and group means were made using Chi square test and Student's t test, respectively.
  
  
  RESULTS
  Protein C and protein S levels were reduced in group A compared with group B and the difference was statistically significant (P=0.005 and P=0.032, respectively). The mean value of antithrombin was slightly reduced in group A compared with group B. APCR was observed in 16.6% cases and 3.3% controls. However, the difference was not statistically significant. APLA was observed in 20% cases and none of the controls. Of these, lupus anticoagulant was positive in 16.6% cases and anticardiolipin antibodies in 10% cases. Combined defects were seen in seven patients.
  
  
  CONCLUSIONS
  There is a significant risk of RPL in pregnant women with thrombophilias. Therefore, screening for thrombophilias may be justified in pregnant women with unexplained recurrent fetal wastage, especially in second and third trimester.
authors.affiliation: Department of Pathology and Obstetrics, Lady Hardinge Medical College and Associated Hospitals, (Opposite Shivaji Stadium), New Delhi, India.
authors.forename: P Lalita
authors.initials: PL
authors.lastname: Jyotsna
authors.forename: Sunita
authors.initials: S
authors.lastname: Sharma
authors.forename: Shubha S
authors.initials: SS
authors.lastname: Trivedi
mesh_terms: D000022:Abortion, Spontaneous / Q000209:etiology*; D020016:Activated Protein C Resistance / Q000150:complications*; D000328:Adult; D016022:Case-Control Studies; D020147:Coagulation Protein Disorders / Q000150:complications*; D005260:Female; D006801:Humans; D011247:Pregnancy; D012008:Recurrence; D019851:Thrombophilia / Q000150:complications*