A successful outcome of pregnancy requires an efficient uteroplacental
vascular system* Since this system may be compromised by disorders of
haemostasis associated with a prothrombotic state, we postulated that
maternal thrombophiiia might be risk factor for fetal loss. The relation of
this thrombophilia and lupus anticoagulant is still unclear and remains to
be defined. So, the aim of this work is to study the thrombogenic potential
in women with recurrent miscarriage, which may be benefit for giving antithrombotic
treatment. For this study, a randomly selected 15 nonpregnant
women and 15 pregnant women with recurrent fetal loss were
compared with another 15 non-pregnant and 15 pregnant normal women,
matched for the same age (20 to 40 years) as controls. The results of this
work showed that, the incidence of LA was about 46.7% in non-pregnant
women while it was 40% in pregnant women. Furthermore, there was
non-significant differences of activated partial thromboplastin timesensitive
LA (APTT-LA), prothrombin time (FT), thrombin time (TT), jibrinogen
concentration, factor VII, factor XII and anti-thrombin III activities
(ATIII) in non-pregnant women who were negative for LA. Meanwhile, factor
VII and XII activities were significantly increased in pregnant women
who were negative for LA (P<0.05) compared with the corresponding control
groups. On the other hand, non-pregnant women who were positive
for LA had a significant increase of plasma Jibrinogen concentration
(P<0.05), APTT-LA, F VII and F XII activities (P<0.001). Meanwhile, plasma
APTT-LA. Jibrinogen concentration, F VII and F XII activities were sig-
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Emad Abdel-Mageed etal...__________________________________________
nificantly increased in pregnant women who were positive for LA (P<0.05)
when compared with their corresponding control group. Plasma TT &
ATIII activity showed non-statistically significant differences bat PT was
significantly decreased in the same group of patients.
We could conclude that although pregnancy is a hypercoagulable
state; but there are certain subgroups of women who were positive for LA
had a more thrombogenic potential which plays a role in recurrent miscarriage.
Thus, we recommend to do AFTT-LA, which is a simple and
cheap test as a screening for every woman with a past history of recurrent
fetal loss. This may be of benefit for the antithrombotic treatment to
improve fetal outcome. |
