INHERITED AND ACQUIRED THROMBOTIC RISK FACTORS IN WOMEN WITH A HISTORY OF OBSTETRIC PATHOLOGY

Objective: to study the detection rate of genetic polymorphisms associated with thrombophilia, as well as the structure of thrombotic risk factors and the pattern of chronic somatic diseases in women with a history of obstetric complications. Subjects and methods. One hundred and five women whose mean age was 30.5±5.1 years were examined. The inclusion criteria were a history of recurrent miscarriage; more than 1 loss at 10 weeks or more gestational age; early fetal death; severe preeclampsia; placental insufficiency; premature detachment of a normally situated placenta; two unsuccessful IVF attempts or more. The exclusion criteria were fetal chromosomal abnormalities with reproductive loss; a patient’s refusal to participate in the study. The investigators performed clinical examination, molecular genetic testing for Factor V Leiden (FVL), F II G20210A, C677T MTHFR, Fgb 455 G>A, Leu33Pro GP IIb/IIIa, PAI-1 675 5G>4G and determined lupus anticoagulant, IgM and IgG anticardiolipin antibodies, β2-glycoprotein 1 antibodies, and made quantitative assay of antithrombin III activity. Results. Inherited thrombophilias were found in 102 (97%) cases; of them 85% women had mixed thrombophilias. Antiphospholipid antibodies were detected in 23% of patients, their association with polymorphisms to thrombotic diseases being observed in 21% of cases. The rate of the detected antiphospholipid syndrome was 3.8%. Other risk factors were encountered with a high frequency; these were chronic endometritis (51%), overweight and obesity (40%), and use of combination oral contraceptives (44%). More than one third of the women had a combination of a few risk factors and chronic extragenital diseases.

inherited thrombophilia, antiphospholipid antibodies, risk factors, pregnancy complications