Hereditary thrombophilia: a differential approach to assessing the risk of obstetric complications


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Hereditary thrombophilias were studied in miscarriage, gestosis, premature detachment of the normally located placenta, cesarean section. The biochip method was used to study thrombophilic polymorphisms. In addition, blood coagulation tests were carried out by 12 indices; D-dimer, homocysteine, and von Willebrand factor were determined.
The higher rate of multigenic thrombophilia was found in the abnormalities under study. Based on the data obtained, the authors developed principles in the assessment of the risk for complications in thrombophilic polymorphisms and an algorithm for diagnostic and medical measures (the use of antiaggregants and anticoagulants).
The determination of the risk for obstetric complications in relation to the results of an examination for hereditary thrombophilia, as well as medical measures could reduce perinatal losses and prevent severe obstetric complications (severe gestosis, placental insufficiency, coagulopathic hemorrhage, fetal growth retardation, premature detachment of the normally located placenta).

作者简介

E Aylamazyan

Marina Zaynulina

Email: zainulina@yandex. ru

E Ailamazyan

D. O. Ott Research Institute of Obstetrics and Gynecology, Russian Academy of Medical Sciences, Saint Petersburg

D. O. Ott Research Institute of Obstetrics and Gynecology, Russian Academy of Medical Sciences, Saint Petersburg

M Zainulina

D. O. Ott Research Institute of Obstetrics and Gynecology, Russian Academy of Medical Sciences, Saint Petersburg

D. O. Ott Research Institute of Obstetrics and Gynecology, Russian Academy of Medical Sciences, Saint Petersburg

参考

  1. Макацария А. Д., Бицадзе В. О. Тромбофилии и противотромботическая терапия в акушерской практике. - М., 2003.
  2. Agnieszka S. M. et al. Inherited thrombophilia in women with recurrent miscarriages and pregnancy loss in anamnesis - own experience // Ginekol. Pol. - 2008. - Vol. 79, N 9. - P. 630-634.
  3. Attia J., Dudding T., Infante-Rivard C. Addendum to: The association between adverse pregnancy outcomes and maternal factor V Leiden genotype. A meta-analysis // Thromb. Haemost. - 2004. - Vol. 92, N 2. - P. 434.
  4. Badawy A. M. et al. Low-molecular weight heparin in patients with recurrent early miscarriages of unknown aetiology // J. Obstetr. Gynaecol. - 2008. - Vol. 28, N 3. - P. 280-284.
  5. Bates S. M. et al. Use of antithrombotic agents during pregnancy: the Seventh ACCP Conference on antithrombotic and thrombolytic therapy // Chest. - 2004. - Vol. 163. - P. 627-644.
  6. Benoni G. et al. Blood conservation with tranexamic acid in total hip arthroplasty: a randomized, double-blind study in 40 primary operations // Acta Ortop. Scand. - 2001. - N 72. - P. 442-448.
  7. Brenner B. Enoxaparin treatment improves the gestational outcome of pregnant women wit thrombophilia and recurrent pregnancy loss: The LIVE-ENOX Study // Blood. - 2003. - Vol. 102. - P. 349-352.
  8. Brenner B., Kupferminc M. J. Inherited thrombophilia and poor pregnancy outcome // Best Pract. Res. Clin. Obstetr. Gynaecol. - 2003. - Vol. 17, N 3. - P. 427-439.
  9. Brown R. S., Thwaites B. K., Mongan P. D. Tranexamic acid is effective in decreasing postoperative bleeding and transfusions in primary coronary artery bypass operations: a double-blind, randomized, placebo-controlled trial // Anesth. Analg. - 1997. - Vol. 85, N 5. - P. 963-970.
  10. Clark P. et al. The GOAL study: a prospective examination of the impact of factor V Leiden and ABO(H) blood groups on haemorrhagic and thrombotic pregnancy outcomes // Br. J. Haematol. - 2008. - Vol. 140, N 2. - P. 236-240.
  11. Comp P. C. et al. Functional and immunologic protein S levels are decreased during pregnancy // Blood. - 1986. - Vol. 68, N 4. - P. 881-885.
  12. Cumming A. M. et al. Development of resistance to activated protein C during pregnancy // Am. J. Haematol. - 1995. - Vol. 90. - P. 725-727.
  13. Gai M. Y. et al. Clinical observation of blood loss reduced by tranexamic acid during and after caesarian section: a multi-center, randomized trial // Eur. J. Obstetr. Gynaecol. Reprod. Biol. - 2004. - Vol. 112, N 2. - P. 154-161.
  14. Grandone E. et al. Antithrombotic prophylaxis during pregnancy in women with deficiency of natural anticoagulants // Blood Coagul. Fibrinolys. - 2008. - Vol. 19, N 3. - P. 226-230.
  15. Greer I. A., Nelson-Piercy C. Low-molecular-weight heparins for thromboprophylaxis and treatment of venous thromboembolism in pregnancy: a systematic review of safety and efficacy // Blood. - 2005. - Vol. 106. - P. 401-407.
  16. Greer I. A. Low molecular weight heparin for pregnancy complications? // Thromb. Res. - 2009. - Vol. 123. - Suppl. 3. - P. 22-25.
  17. Kosmas I. P., Tatsioni A., Ioannidis J. P. Association of Leiden mutation in factor V gene with hypertension in pregnancy and pre-eclampsia: a meta-analysis // J. Hypertens. - 2003. - Vol. 21, N 7. - P. 1221-1228.
  18. Kosmas I. P., Tatsioni A., Ioannidis J. P. Association of C677T polymorphism in the methylenetetrahydrofolate reductase gene with hypertension in pregnancy and preeclampsia: a meta-analysis // J. Hypertens. - 2004. - Vol. 22, N 9. - P. 1655- 1662.
  19. Kovalevsky G. et al. Evaluation of the association between hereditary thrombophilias and recurrent pregnancy loss: a meta-analysis // Arch. Intern. Med. - 2004. - Vol. 164, N 5. - P. 558-563.
  20. Lindqvist P. G. et al. Activated protein C resistance (FV:Q506) and pregnancy // Thromb. Haemost. - 1999. - Vol. 81, N 4. - P. 532-537.
  21. Monien S. et al. Use of heparin in women with early and late miscarriages with and without thrombophilia // Clin. Appl. Thromb. Hemost. - 2009. - Vol. 15, N 6. - P. 636-644.
  22. Murphy R. P. et al. Prospective evaluation of the risk conferred by factor V Leiden and thermolabile methylenetetrahydrofolate reductase polymorphisms in pregnancy // Arterioscler. Thromb. Vasc. Biol. - 2000. - Vol. 20, N 1. - P. 266-270.
  23. Nelson S. M. Prophylaxis of VTE in women - during assisted reproductive techniques // Thromb. Res. - 2009. - Vol. 123. - Suppl. 3. - P. 8-15.
  24. van Pampus M. G. et al. High prevalence of hemostatic abnormalities in women with a history of severe preeclampsia // Am. J. Obstetr. Gynecol. - 1999. - Vol. 180, N 5. - P. 1146- 1150.
  25. Preston F. E. et al. Increased fetal loss in women with heritable thrombophilia // Lancet. - 1996. - Vol. 348, N 9032. - P. 913-916.
  26. Rai R. et al. Factor V Leiden and acquired activated protein C resistance among 1000 women with recurrent miscarriage // Hum. Reprod. - 2001. - Vol. 16, N 5. - P. 961-965.
  27. Rey E. et al. Thrombophilic disorders and fetal loss: a meta-analysis // Lancet. - 2003. - Vol. 361, N 9361. - P. 901- 908.
  28. Robertson L. et al. Thrombophilia in pregnancy: a systematic review. Thrombosis: Risk and Economic Assessment of Thrombophilia Screening (TREATS) Study // Br. J. Haematol. - 2006. - Vol. 132, N 2. - P. 171-196.
  29. Ruffatti A. et al. Efficacy and safety of nadroparin in the treatment of pregnant women with antiphospholipid syndrome: a prospective cohort study // Lupus. - 2005. - Vol. 14, N 2. - P. 120-128.
  30. Tanaka N. J. et al. Timing of the administration of tranexamic acid for maximum reduction in blood loss in arthroplasty of the knee // J. Bone Jt Surg. Br. - 2001. - Vol. 83, N 5. - P. 702-705.
  31. Waterstone M., Bewley S., Wolfe C. Incidence and predictors of severe obstetric morbidity: case-control study // Br. Med. J. - 2001. - Vol. 322. - P. 1089-1093.
  32. Yang H., Zheng S., Shi C. Clinical study on the efficacy of tranexamic acid in reducing postpartum blood loss: a randomized, comparative, multicenter trial // Zhonghua Fu Chan Ke Za Zhi. - 2001. - Vol. 36, N 10. - P. 590-592.
  33. Zidane M. et al. Out of hospital treatment with subcutaneous low molecular weight heparin in patients with acute deep-vein thrombosis: a prospective study in daily practice // Haematologica. - 2006. - Vol. 91, N 8. - P. 1052-1058.

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