Document Detail


Thrombophilias and recurrent pregnancy loss.
MedLine Citation:
PMID:  16418978     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Thrombophilia by definition represents acquired and/or genetic conditions that predispose patients to both venous and arterial thromboembolic events. Thrombosis is the most common cause of death worldwide. On the arterial side, myocardial infarction and stroke result in significant morbidity and mortality. Venous thromboembolic events most commonly involve the deep veins of the lower extremity with potential complications of pulmonary emboli. Pregnancy is a hypercoagulable state, and thromboembolism is the leading cause of antepartum and postpartum maternal mortality. With the description by Dahlback in 1993 of a condition initially labeled activated protein C resistance, significant advances have rapidly followed. Activated protein C resistance was linked to an underlying point mutation resulting in coagulation factor V (factor V Leiden). Recent attention has focused on certain inherited thrombophilic factors that may predispose to arterial and/or venous thromboses and their possible association with pregnancy complications, including early pregnancy loss. These include a group of mostly autosomal dominant, inherited gene mutations leading to a hypercoagulable state, such as factor V Leiden G1691A, factor II or prothrombin G20210A, and hyperhomocysteinemia associated with methylenetetrahydrofolate reductase C677T mutation. In addition, deficiencies in protein S, protein C, and antithrombin can lead to a hypercoagulable state. Although some studies of recurrent pregnancy loss patients with a positive test for an inherited thrombophilia are conflicting, a case-control study of untreated recurrent miscarriage patients who were heterozygous for the factor V Leiden mutation revealed a lower success rate than the controls who had a history of idiopathic recurrent miscarriage. With the identification of genetic risk factors, there has been synergistic amplification of thrombotic risk when one has an abnormal gene (e.g., factor V Leiden) plus environmental issues (e.g., pregnancy). Current understanding indicates that a combination of risk factors, including multiple inherited thrombophilic defects associated with secondary hypercoagulable states, have a particularly strong association with adverse pregnancy outcome.
Authors:
William H Kutteh; Douglas A Triplett
Related Documents :
21585638 - Perinatal mortality and mode of delivery in monochorionic diamniotic twin pregnancies ≥...
22764428 - Predictors of fetal demise after trauma in pregnant saudi arabian women.
10698038 - Activated protein c resistance and factor v leiden mutation can be associated with firs...
12413068 - Heparin and osteoporosis during pregnancy: 2002 update.
22825278 - Pregnancy in an intestinal transplant recipient.
12069538 - Inborn errors presenting with liver dysfunction.
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Seminars in reproductive medicine     Volume:  24     ISSN:  1526-8004     ISO Abbreviation:  Semin. Reprod. Med.     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-01-18     Completed Date:  2006-03-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100909394     Medline TA:  Semin Reprod Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  54-66     Citation Subset:  IM    
Affiliation:
University of Tennessee, Memphis, Memphis, Tennessee 38120-2363, USA. wkutteh@utmem.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Abortion, Habitual / etiology*,  genetics,  metabolism
Factor V / genetics
Female
Humans
Hyperhomocysteinemia / complications,  genetics
Point Mutation
Pregnancy
Pregnancy Complications, Hematologic / physiopathology*
Protein C Deficiency / complications,  genetics
Protein S Deficiency / complications,  genetics
Thrombophilia / complications*,  genetics,  metabolism
Chemical
Reg. No./Substance:
0/factor V Leiden; 9001-24-5/Factor V

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


Previous Document:  Obstetrical antiphospholipid syndrome.
Next Document:  Preventing catheter-associated bloodstream infections: a survey of policies for insertion and care o...