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Clinical and Experimental Obstetrics & Gynecology  2017, Vol. 44 Issue (5): 749-754    DOI: 10.12891/ceog3556.2017
Original Research Previous articles | Next articles
Inherited thrombophilia and thromboprophylaxis: a retrospective analysis of pregnancy outcomes in 106 patients
H. Alptekin1, *(), N. Alptekin2, R. Selimoğlu1, T. Cengiz1, S. Barış3
1 Department of Obstetrics and Gynecology, Mevlana University Faculty of Medicine, Konya, Turkey
2 Department of Pediatrics, Mevlana University Faculty of Medicine, Konya, Turkey
3 Department of Medical Genetics, Mevlana University Faculty of Medicine, Konya, Turkey
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Abstract  
Objective: Low-molecular-weight heparin (LMWH) and low-dose aspirin (LDA) given in combination were evaluated in females with five commonly inherited thrombophilia polymorphisms to address unexplained recurrent pregnancy loss (RPL). Materials and Methods: After excluding other causes of RPL, 106 of 183 females suffering RPL and diagnosed with inherited thrombophilia were studied along with 62 healthy, age-matched control subjects carrying one or more pregnancies successfully (no gestational complications or abortion). Test patients were given a combination of LMWH and LDA. All participants were screened for five thrombophilic mutations: factor V Leiden G1691A, prothrombin (FII) A20210G, PAI-1 4G/5G insertion/deletion, and two methylenetetrahydrofolate reductase (MTHFR) polymorphisms (C677T and A1298C). Results: With thromboprophylaxis, 73 of 84 (86.9%) pregnancies succeeded, representing a significant increase in the rate of live births (vs. 232 prior losses). Of the five test panel mutations, three or more (homozygous and/or heterozygous) were observed in 48 test patients (45.3%), whereas only three control subjects (4.8%) were similarly affected (p < 0.05). Frequencies of all five mutations were significantly higher in test patients (vs. controls), with PAI-1 4G/5G and MTHFR (C677T and A1298C) identified via binary logistic regression as independent correlates of habitual abortion. Conclusion: The risk of RPL increases with three or more homozygous or heterozygous genotypes in inherited thrombophilia, especially with PAI-1 4G/5G and MTHFR (C677T and A1298C). As in acquired thrombophilia, LMWH/LDA combination treatment may increase live birth rates in patients with inherited thrombophilia.
Key words:  Inherited thrombophilia      Thromboprophylaxis      Recurrent pregnancy loss      Low-molecular-weight heparin      Low-dose aspirin     
Published:  10 October 2017     
*Corresponding Author(s):  H. ALPTEKİN     E-mail:  alptekinhusnu74@hotmail.com

Cite this article: 

H. Alptekin, N. Alptekin, R. Selimoğlu, T. Cengiz, S. Barış. Inherited thrombophilia and thromboprophylaxis: a retrospective analysis of pregnancy outcomes in 106 patients. Clinical and Experimental Obstetrics & Gynecology, 2017, 44(5): 749-754.

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https://ceog.imrpress.com/EN/10.12891/ceog3556.2017     OR     https://ceog.imrpress.com/EN/Y2017/V44/I5/749

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[2] Xiaomin Kanga, Tongfei Wanga, Shijin Xiaoa, Aimin Zhaoa. A successful pregnancy following 11 miscarriages in an unexplained recurrent pregnancy loss patient with thrombophilia: a case report and literature review[J]. Clinical and Experimental Obstetrics & Gynecology, 2018, 45(6): 935-938.
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