Document Detail


A possible role for activated protein C resistance in patients with first and second trimester pregnancy failure.
MedLine Citation:
PMID:  10357988     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Thrombophilia was recently suggested as a possible factor in recurrent pregnancy losses. We studied prospectively 125 patients (mean age 31.4 +/- 5.6 years) with one or more first or second trimester pregnancy losses for the prevalence of activated protein C resistance (APCR). Proteins C and S antigens, antithrombin III, anticardiolipin, and lupus anti-coagulant were also evaluated. Patients with uterine malformations, hormonal abnormalities, chromosomal translocations and infectious causes were excluded. A control group of 125 women with no past fetal loss were matched with the study group. Whenever the APC-sensitivity ratio (APC-SR) was </=2.2, polymerase chain reaction for factor V mutation (Leiden) was performed. Heterozygosity for the mutation was found in 18 patients (14.4%) compared with seven heterozygous among 125 control group (5. 6%; P < 0.05). Acquired APCR (APC-SR 1.8 and Leiden negative) was revealed in seven patients (5.6%) in the study group and in three of the controls (2.4%; not significant). The rate of preclinical pregnancy losses (17/48) and second trimester miscarriages (10/48) in mutation carriers was significantly higher than in patients with no APCR (25/214) and (14/214) respectively (P < 0.001 and P < 0.01 respectively). Live birth rate was not different between the two groups. Occurrence of APCR with any kind of pregnancy loss calculated per patient, in our study group, was approximately 1/7, 1/4 and 1/5 with one, two and three or more pregnancy losses respectively. These findings suggest that assessment of APCR should be considered in a more extended evaluation of such patients.
Authors:
J Tal; L M Schliamser; Z Leibovitz; G Ohel; D Attias
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  14     ISSN:  0268-1161     ISO Abbreviation:  Hum. Reprod.     Publication Date:  1999 Jun 
Date Detail:
Created Date:  1999-07-08     Completed Date:  1999-07-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1624-7     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Bnai-Zion Medical Center, Rappaport Faculty of Medicine, Technion, 47 Golomb St, PO Box 4049, Haifa 31048, Israel.
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MeSH Terms
Descriptor/Qualifier:
Abortion, Spontaneous / etiology*
Activated Protein C Resistance / complications*,  genetics
Adult
Antibodies, Anticardiolipin / blood
Antithrombin III / analysis
Chromosome Aberrations
Factor V / analysis,  genetics
Female
Gestational Age*
Humans
Lupus Coagulation Inhibitor / blood
Mutation
Pregnancy
Protein C / analysis
Protein S / analysis
Chemical
Reg. No./Substance:
0/Antibodies, Anticardiolipin; 0/Lupus Coagulation Inhibitor; 0/Protein C; 0/Protein S; 0/factor V Leiden; 9000-94-6/Antithrombin III; 9001-24-5/Factor V

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