Document Detail


Respective evaluation of the prevalence of haemostasis abnormalities in unexplained primary early recurrent miscarriages. The Nimes Obstetricians and Haematologists (NOHA) Study.
MedLine Citation:
PMID:  9241739     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The prevalence of haemostasis abnormalities was evaluated in 500 consecutive women with unexplained primary recurrent miscarriages. Two matched reference groups with no antecedent of miscarriage were studied: 100 healthy mothers and 50 childless women. In the prospective part of the study, we found 9.4% of the patients (95% C.I.: 6.8-12%) with an isolated factor XII deficiency, 7.4% of the patients (5.0-9.8%) with primary antiphopholipid antibodies, 47% of the patients (42.6-51.4%) with an insufficient response to the venous occlusion test and an isolated hypofibrinolysis was found in 42.6% (38.2-47%) of the patients (reference groups: respectively 0/150, 3/150, 2/150, p < 10(-3)). Willebrand disease, fibrinogen, deficiency, antithrombin, protein C or protein S deficiencies were not more frequent in recurrent aborters than in members of the reference groups. In the retrospective part of the study, cases of plasma resistance to activated protein C were not abnormally frequent. Patients had higher Willebrand factor antigen (vWF), tissue-type plasminogen activator antigen (t-PA), plasminogen activator inhibitor activity (PAI) and D-dimers (D-Di) than the reference women. Values of vWF, t-PA, PAI and D-Di were altogether correlated but were not related to C-reactive protein concentrations. Among patients, those with an antiphospholipid syndrome and those with an insufficient response to the venous occlusion test had higher vWF, t-PA, PAI and D-Di values than the patients with none of the haemostasis-related abnormalities. Thus, factor XII deficiency and hypofibrinolysis (mainly high PAI) are the most frequent haemostasis-related abnormalities found in unexplained primary recurrent aborters. In patients with antiphospholipid antibodies or hypofibrinolysis, there is a non-inflammatory ongoing chronic elevation of markers of endothelial stimulation associated with coagulation activation. This should allow to define subgroups of patients for future therapeutic trials.
Authors:
J C Gris; S Ripart-Neveu; C Maugard; M L Tailland; S Brun; C Courtieu; C Biron; M Hoffet; B Hédon; P Marès
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Thrombosis and haemostasis     Volume:  77     ISSN:  0340-6245     ISO Abbreviation:  Thromb. Haemost.     Publication Date:  1997 Jun 
Date Detail:
Created Date:  1997-09-11     Completed Date:  1997-09-11     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  7608063     Medline TA:  Thromb Haemost     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  1096-103     Citation Subset:  IM    
Affiliation:
Consultations et Laboratoire d'Hématologie, CHU, Nimes, France.
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MeSH Terms
Descriptor/Qualifier:
Abortion, Habitual / blood*,  physiopathology
Adult
Antigens / analysis
Factor XII Deficiency / blood,  physiopathology
Female
Fibrinolysis
Hemostasis*
Humans
Pregnancy
Prospective Studies
von Willebrand Factor / immunology
Chemical
Reg. No./Substance:
0/Antigens; 0/Von Willebrand antigen; 0/von Willebrand Factor

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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