PREVENTION OF COMPLICATIONS OF PREGNANCY IN FACTOR V LEIDEN MUTATION CARRIERS


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Abstract

Objective. To investigate the clinical and laboratory protective effects of heparin in Factor VLeiden (FVL) (1691) GA genotype carriers with a marked activated protein C (APC) resistance. Subjects and methods. A single-center randomized controlled study was conducted in 141 pregnant women [the FVL (1691) GA genotype] with APC resistance by an international normalized ratio (INR) of 0.49 or less. The study group patients (n=70) received heparin prophylaxis cycles at 7-8 weeks’ gestation; the comparison groups of pregnant women (n=71) did not use low-molecular-weight heparin (LMWH). Results. During LMWH treatment, there were thrombin generation decreases determined by the thrombin generation test indicators: peak thrombin by 9-11% (p=0.008), endogenous thrombin potential (ETP) by 4-9% (p=0.013), and APC resistance by 9-14% (p < 0.05). The clinical protective effects of heparin were defined as a reduction in the absolute risk of developing preeclampsia by 29.5% (p=0.0003), fetal growth restriction by 23.8% (p=0.002), and preterm births by 12.6% (p=0.024). Conclusion. Prophylaxis with heparin is pathogenetically justified and causes a significant decline in the number of pregnancy complications in FVL (1691) GA genotype carriers with a marked APCresistance (INR 40.49)

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About the authors

Maria G. Nikolaeva

Altai State Medical University, Ministry of Health of the Russian Federation

Email: nikolmg@yandex.ru
MD, associate professor of the Department of Obstetrics and Gynecology 40, Lenin Pr., Barnaul 656038, Russia

Andrey P. Momot

National Medical Research Center of Hematology, Ministry of Health of the Russian. Altai Branch

Email: xyzan@yandex.ru
MD, Professor, Director 1, Lyapidevsky St., Barnaul 656045, Russia

Marina S. Zainulina

I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia

Email: zainulina@yandex.ru
Professor, MD, Professor of the Department of Obstetrics, Gynecology and Reproduction

Natalia N. Yasafova

Altai Territorial Clinical Hospital

Email: jasafova@mail.ru
hematologist 1, Lyapidevsky St., Barnaul 656045, Russia

Ksenia A. Momot

Altai Territorial Clinical Hospital

Email: mslove88@mail.ru
hematologist 1, Lyapidevsky St., Barnaul 656045, Russia

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