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Thrombophilia in pregnancy

N V Bashmakova, N B Davydenko, G B Malgina, N V Putilova
AIM: The aim of this research was to have a thorough study of predictors of critical states during pregnancy after assisted reproductive technologies. MATERIALS AND METHODS: A retrospective study of 303 patients with "near-miss," out of which 37 are pregnancy cases after ART (the main group) and 265 are spontaneous pregnancy cases (the control group). RESULTS: Pregnancy after ART constituted 12.3% of all critical states. In the main group (10...
October 2016: Gynecological Endocrinology
Marc A Rodger, Jean-Christophe Gris, Johanna I P de Vries, Ida Martinelli, Évelyne Rey, Ekkehard Schleussner, Saskia Middeldorp, Risto Kaaja, Nicole J Langlois, Timothy Ramsay, Ranjeeta Mallick, Shannon M Bates, Carolien N H Abheiden, Annalisa Perna, David Petroff, Paulien de Jong, Marion E van Hoorn, P Dick Bezemer, Alain D Mayhew
BACKGROUND: Placenta-mediated pregnancy complications include pre-eclampsia, late pregnancy loss, placental abruption, and birth of a small-for-gestational-age (SGA) neonate. These complications are leading causes of maternal, fetal, and neonatal morbidity and mortality in high-income countries. Affected women are at high risk of recurrence in subsequent pregnancies; however, effective strategies to prevent recurrence are absent. Findings from our previous study-level meta-analysis suggested that low-molecular-weight heparin reduced the risk of recurrent placenta-mediated pregnancy complications...
October 6, 2016: Lancet
Juan Jesús Fernández-Alba, Carmen González-Macías, Angel Vilar Sánchez, Pilar Tajada Cepero, Raquel Garrido Teruel, María José García-Cabanillas, Luis Javier Moreno-Corral, Rafael Torrejón Cardoso
OBJECTIVE: To determine the risk of small-for-gestational-age (SGA) and intrauterine growth retardation (IUGR) in pregnant women with protein S (PS) deficiency who received low-molecular-weight heparin (LMWH). METHODS: Retrospective cohort study of pregnant women seen from January 2002 to December 2011. The study cohort comprised a total of 328 patients with PS deficiency, who received prophylactic enoxaparin during pregnancy. The control cohort included 11 884 pregnant women without significant past medical history...
October 17, 2016: Journal of Maternal-fetal & Neonatal Medicine
Gi Su Lee, Joon Cheol Park, Jeong Ho Rhee, Jong In Kim
OBJECTIVE: The goal of this study was to evaluate the etiologies and clinical outcomes of Korean recurrent pregnancy loss (RPL) patients. And also, we investigated the differences between primary and secondary RPL patients, between two and three or more pregnancy losses. METHODS: One hundred seventy eight women diagnosed as RPL were enrolled. We performed chromosomal analysis, thyroid stimulating hormone, prolactin, blood glucose, plasminogen activator inhibitor-1, natural killer cell proportion, anticardiolipin antibodies, antiphospholipid antibodies, lupus anticoagulant, anti-β2glycoprotein-1 antibodies, antinuclear antibody, protein C, protein S, antithrombin III, homocysteine, MTFHR gene, factor V Leiden mutation, and hysterosalphingography/hysteroscopic evaluation...
September 2016: Obstetrics & Gynecology Science
Laura Ormesher, Louise Simcox, Clare Tower, Ian A Greer
Adverse pregnancy outcomes, such as pregnancy loss and pre-eclampsia, are associated with thrombotic mechanisms and thrombophilia. Antithrombotic interventions, particularly low-molecular-weight heparin, have been investigated in women identified by previous pregnancy outcome; however, the results have been inconsistent. This may reflect heterogeneity of both the study groups and the disease processes resulting in inadequate stratification to guide antithrombotic interventions. Furthermore, the variation in gestation at initiation of low-molecular-weight heparin treatment might be important...
July 2016: Women's Health
V Salle, J Schmidt, A Smail, C Mazière, M A Conte, A Brulé, J C Mazière, E Cadet, Y E Herpe, P Duhaut
Acquired and inherited thrombophilia have both been reported to be associated with an increased risk of obstetric complications in early or later stages of pregnancy. Annexin A2 (ANXA2) is strongly expressed in vascular and placental tissues and plays a crucial role in fibrinolysis. The aim of the present study was to evaluate the prevalence of antibodies directed against ANXA2 in patients with recurrent miscarriage or obstetric complications. Anti-ANXA2 antibodies (aANXA2) were detected by ELISA in the sera from 46 women with obstetric morbidity, mainly recurrent miscarriage...
August 30, 2016: Journal of Reproductive Immunology
Oner Aynıoglu, Hatice Isik, Ahmet Sahbaz, Husnu Alptekın, Ulku Bayar
OBJECTIVES: Recurrent pregnancy loss (RPL) is a serious problem in the reproductive age women. We aimed to study the role of anticoagulant therapy on pregnancy complications and perinatal outcomes in pregnant patients with histories of RPL. MATERIAL AND METHODS: One hundred fifty-three pregnants, with RPL history and thrombophilia positivity, were grouped into two as 89 treated with anticoagulant therapy and 64 non-treated. Treated and untreated groups were compared for pregnancy complications, delivery weeks, abortion rates, fetal birth weights, APGAR scores, live birth rates, and newborn intensive care admission rates...
2016: Ginekologia Polska
Eran Weiner, Hadas Miremberg, Ehud Grinstein, Letizia Schreiber, Shimon Ginath, Jacob Bar, Michal Kovo
BACKGROUND: The mechanisms involved in bleeding in cases of placenta previa (PP) and the effect on pregnancy outcome is unclear. OBJECTIVES: We aimed to compare pregnancy outcome and placental histopathology in pregnancies complicated with symptomatic (bleeding) vs. non-symptomatic PP, and to study the effects of the co-existence of histopathological retro-placental hemorrhage (RPH) in cases of symptomatic PP on neonatal and maternal outcomes. STUDY DESIGN: Labor and maternal characteristics, neonatal outcome and placental histopathology lesions of pregnancies with PP, delivered between 24 and 42weeks, during 2009-2015, were reviewed...
October 2016: Early Human Development
Amihai Rottenstreich, Nael Da'as, Geffen Kleinstern, Galia Spectre, Hagai Amsalem, Yosef Kalish
OBJECTIVE: To collect and summarize demographic, clinical, laboratory and radiologic characteristics, as well as management and follow-up data, of patients diagnosed with ovarian vein thrombosis. METHODS: A multicenter retrospective review of all patients diagnosed with ovarian vein thrombosis between January 2000 and May 2015 at three university hospitals. RESULTS: Data of 74 women were analyzed. Mean age was 31±9years. Sixty (81.1%) cases were pregnancy-related...
October 2016: Thrombosis Research
Andrea Gerhardt, Rüdiger E Scharf, Ian A Greer, Rainer B Zotz
Venous thromboembolism (VTE) is a leading cause of maternal mortality. Few studies have evaluated the individual risk of gestational VTE associated with heritable thrombophilia and current recommendations for antenatal thromboprophylaxis in women with severe thrombophilia such as homozygous factor V Leiden mutation (FVL) depend on a positive family history of VTE. To better stratify thromboprophylaxis in pregnancy, we aimed to estimate the individual probability (absolute risk) of gestational VTE associated with thrombophilia and whether these risk factors are independent of a family history of VTE in first-degree relatives...
September 9, 2016: Blood
Vandana Rai
The C677T polymorphism of the methylenetetrahydrofolate reductase (MTHFR) gene was implicated to be associated with thrombophilia due to its role in catalyzing the formation of 5-methylenetetrahydrofolate, a co-substrate for the conversion of homocysteine to methionine. Several case-control studies were investigated MTHFR C677T polymorphism as risk for recurrent pregnancy loss (RPL). These studies rendered contradictory results, some indicating that the polymorphism is associated with the risk of RPL whereas others concluded there is no association...
October 2016: Indian Journal of Clinical Biochemistry: IJCB
I Martinelli, S M Passamonti, A Maino, M Abbattista, P Bucciarelli, E Somigliana, A Artoni, F Gianniello, F Peyvandi
: Essentials Little is known about recurrences and pregnancy outcome after cerebral vein thrombosis (CVT). We studied a cohort of pregnant women with CVT. Women with CVT appear at increased risk of late obstetrical complications despite prophylaxis. Risks of recurrent thrombosis and bleeding in women on heparin prophylaxis while pregnant are low. SUMMARY: Background The risk of recurrent thrombosis and bleeding episodes in women with previous cerebral vein thrombosis (CVT) on antithrombotic prophylaxis with low-molecular-weight heparin (LMWH) during pregnancy is not established and little information is available on pregnancy outcome...
September 6, 2016: Journal of Thrombosis and Haemostasis: JTH
Samia Ben Sassi, Nahla Touati, Hela Baccouche, Cyrine Drissi, Neila Ben Romdhane, Fayçal Hentati
OBJECTIVE: Data regarding cerebral venous thrombosis in North Africa are scarce. This study aims to identify the clinical features, risk factors, outcome, and prognosis of cerebral venous thrombosis in Tunisia. METHODS: Data of 160 patients with radiologically confirmed cerebral venous thrombosis, hospitalized in Mongi Ben Hmida National Institute of Neurology (Tunis, Tunisia), were retrospectively collected and analyzed. RESULTS: The mean age was 37...
August 31, 2016: Clinical and Applied Thrombosis/hemostasis
Stephan G Dixon, Carl T Bruce, Charles J Glueck, Robert A Sisk, Robert K Hutchins, Vybhav Jetty, Ping Wang
AIM: Our specific aim was to document the pathoetiologic importance of thrombophilia among females presenting with severe ischemic retinal vein (RVO) or retinal artery (RAO) occlusion, without typical risk factors, and to emphasize that the ophthalmologists' diagnosis of thrombophilia has important diagnostic and therapeutic downstream ramifications for nonocular thrombosis, including reproductive outcomes. METHODS: We evaluated familial and acquired thrombophilia in 60 females with RVO (central RVO, n=52; branch RVO, n=8) and 16 with RAO (central RAO, n=11; branch RAO, n=5)...
2016: Clinical Ophthalmology
Leslie Ordal, Johannes Keunen, Nicole Martin, Nadine Shehata, Gregory H Borschel, Howard M Clarke, Ants Toi, Cheryl Shuman, David Chitayat
Congenital limb deficiency defects (LDDs) are etiologically heterogeneous. Acquired causes include amniotic bands, teratogens exposure, and chorionic villus sampling before 10 weeks' gestation and intrinsic causes include single-gene disorders and chromosome abnormalities. However, a substantial number of cases, especially terminal transverse deficiency defects, occur without an obvious cause and are ascribed to vascular disruption events. Some studies have found an association between maternal thrombophilia and congenital LDDs...
August 17, 2016: American Journal of Medical Genetics. Part A
Mehtap Polat, Ebru Hacer Biberoğlu, İsmail Güler, Ömer Kutay Biberoğlu
BACKGROUND/AIM: To examine the relationship of inherited thrombophilia and other thrombotic risk factors with preeclampsia (PE) in a population of pregnant Turkish women. MATERIALS AND METHODS: This was a case cross-sectional study in which 70 women with PE and 60 normal pregnant women were studied to find out the frequency of women with risk factors including inherited thrombophilia among preeclamptic cases. RESULTS: Hemoglobin, platelet count, uric acid, vitamin B12, folic acid, copper, homocysteine, plasminogen activator inhibitor-1, fibrinogen, protein S, protein C, activated protein C resistance values show significant differences in women with PE in comparison to women with normal pregnancy...
2016: Turkish Journal of Medical Sciences
Magdalena Barlik, Agnieszka Seremak-Mrozikiewicz, Krzysztof Drews, Andrzej Klejewski, Grażyna Kurzawińska, Zdzisław Łowicki, Hubert Wolski
BACKGROUND: Polymorphisms which are presented below may be the cause of inherited thrombophilia and may result in pregnancy loss. The hypothesis is based on a number of cardiology studies which have confirmed the involvement of these polymorphisms in thrombotic incidents. OBJECTIVES: To evaluate the role of polymorphisms of factor VII gene (Arg353Gln, -122T > C) and PAI-1 gene (-675 4G/5G) in the etiology of recurrent miscarriage. MATERIAL AND METHODS: The study group included 152 women with a positive history of ≥ 2 consecutive pregnancy losses (114 and 38 women with 2 and ≥ 3 miscarriages, respectively), while 180 healthy women were recruited as controls...
2016: Ginekologia Polska
Raed Salim, Zohar Nachum, Israel Gavish, Shabtai Romano, Meirav Braverman, Gali Garmi
Women with thrombophilias and previous placenta-mediated pregnancy complications (PMPC) have an increased risk of both recurrent PMPC and venous thromboembolism (VTE) during subsequent pregnancies. We aimed to examine whether enoxaparin dose adjusted according to anti-factor Xa levels compared to a fixed dose would reduce the risk of PMPC in subsequent pregnancies. In a randomised trial, conducted at a single teaching hospital, pregnant women with thrombophilia and previous PMPC were enrolled in a 1:1 ratio to either a fixed dose of 40 mg daily enoxaparin or adjusted dose according to anti-factor Xa plasma levels...
September 27, 2016: Thrombosis and Haemostasis
Salvatore Andrea Mastrolia, Lena Novack, Jecko Thachil, Anat Rabinovich, Oleg Pikovsky, Vered Klaitman, Giuseppe Loverro, Offer Erez
Placental mediated pregnancy complications such as preeclampsia and fetal growth restriction (FGR) are common, serious, and associated with increased morbidity and mortality. We conducted a systematic review and meta-analysis to determine the effect of treatment with low-molecular-weight heparins (LMWHs) for secondary prevention of these complications in non thrombophilic women. We searched the electronic databases PubMed, Scopus, and Cochrane Library for randomised controlled trials addressing this question...
July 21, 2016: Thrombosis and Haemostasis
Baris Ata, Bulent Urman
PURPOSE: The aim of this study is to provide an overview of the studies investigating a possible association between thrombophilia and assisted reproductive technology (ART) outcome. METHODS: This is a literature review. RESULTS: Congenital thrombophilias (CoT) are reported to be associated with pregnancy loss. However, the association between CoT and early pregnancy loss is weak and does not necessarily support causation. CoT are more likely to be associated with late fetal loss...
July 16, 2016: Journal of Assisted Reproduction and Genetics
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