title: Platelet function in patients with a history of unexplained recurrent miscarriage who subsequently miscarry again.
abstract: OBJECTIVE
  This study was designed to evaluate platelet aggregation in pregnant women with a history of unexplained recurrent miscarriage (RM) and to compare platelet function in such patients who go on to have either another subsequent miscarriage or a successful pregnancy.
  
  
  METHODS
  A prospective longitudinal study was performed to evaluate platelet function in a cohort of patients with a history of unexplained RM. Platelet reactivity testing was performed at 4-7 weeks gestation, to compare platelet aggregation between those with a subsequent miscarriage and those who had successful live birth outcomes. Platelet aggregation was calculated using a modified assay of light transmission aggregometry with multiple agonists at different concentrations.
  
  
  RESULTS
  In a cohort of 39 patients with a history of RM, 30 had a successful pregnancy outcome while nine had a subsequent miscarriage again. Women with subsequent miscarriage had reduced platelet aggregation in response to adenosine diphosphate (P value 0.0012) and thrombin receptor activating peptide (P value 0.0334) when compared to those with successful pregnancies. Women with subsequent miscarriages also had a trend towards reduced platelet aggregation in response to epinephrine (P value 0.0568).
  
  
  CONCLUSIONS
  Patients with a background history of unexplained RM demonstrate reduced platelet function if they have a subsequent miscarriage compared to those who go on to have a successful pregnancy.
authors: Royal College of Surgeons in Ireland, Ireland. Electronic address: mdempsey@rcsi.ie.
authors: Mark Anthony
authors: MA
authors: Dempsey
authors: Royal College of Surgeons in Ireland, Ireland.
authors: Karen
authors: K
authors: Flood
authors: Royal College of Surgeons in Ireland, Ireland.
authors: Naomi
authors: N
authors: Burke
authors: Royal College of Surgeons in Ireland, Ireland.
authors: Aoife
authors: A
authors: Murray
authors: Royal College of Surgeons in Ireland, Ireland.
authors: Brian
authors: B
authors: Cotter
authors: Royal College of Surgeons in Ireland, Ireland.
authors: Sieglinde
authors: S
authors: Mullers
authors: Royal College of Surgeons in Ireland, Ireland.
authors: Patrick
authors: P
authors: Dicker
authors: Royal College of Surgeons in Ireland, Ireland.
authors: Patricia
authors: P
authors: Fletcher
authors: Royal College of Surgeons in Ireland, Ireland.
authors: Michael
authors: M
authors: Geary
authors: Royal College of Surgeons in Ireland, Ireland.
authors: Dermot
authors: D
authors: Kenny
authors: Royal College of Surgeons in Ireland, Ireland.
authors: Fergal D
authors: FD
authors: Malone
mesh_terms: D000026:Abortion, Habitual / Q000097:blood*; D000244:Adenosine Diphosphate / Q000494:pharmacology; D000322:Adrenergic Agonists / Q000494:pharmacology; D000328:Adult; D001792:Blood Platelets / Q000502:physiology*; D004837:Epinephrine / Q000494:pharmacology; D005260:Female; D005865:Gestational Age; D006801:Humans; D050498:Live Birth; D008137:Longitudinal Studies; D010446:Peptide Fragments / Q000494:pharmacology; D010974:Platelet Aggregation / Q000187:drug effects*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies
chemical_list: D000322:Adrenergic Agonists; D010446:Peptide Fragments; C086309:thrombin receptor peptide SFLLRNP; D000244:Adenosine Diphosphate; D004837:Epinephrine
keywords: Platelet aggregation; Recurrent miscarriage