Obstet Gynecol Sci.  2015 Nov;58(6):514-517. 10.5468/ogs.2015.58.6.514.

Inherited thrombophilia profile in patients with recurrent miscarriages: Experience from a tertiary care center in north India

• Kumar N
• Ahluwalia
• Das R
• Rohilla M
• Bose S
• Kishan H
• Varma N

• KMID: 2314069
• DOI: http://doi.org/10.5468/ogs.2015.58.6.514

Abstract

The cause of recurrent miscarriage (RM) remains unexplained in approximately 30% to 50% cases. The association of inherited thrombotic factors and RM patients has not been documented from the northern part of India. A total of 40 patients had been investigated for inherited thrombophilia workup (protein C, protein S [PS], antithrombin III, and factor V Leiden [FVL] mutation) over a period of 10 years (2005 to 2014). RM patients were divided in to three groups. Group I (only 1st trimester loss), group II (only 2nd and 3rd trimester), and group III (mixed). Each group comprised of the following numbers of patients respectively: I, 24; II, 2; III, 14. Heterozygous FVL mutation was found in 10% (4/40) cases. PS deficiency was detected in 2.7% (1/37) cases. In the present study FVL and PS were seems to be associated with a subset of patients however further studies with larger numbers of patients are recommended for better evaluation.

Keyword

Abortion, habitual; Factor V Leiden; Protein S; Thrombophilia

MeSH Terms

Abortion, Habitual*
Antithrombin III
Factor V
Female
Humans
India*
Pregnancy
Protein S
Tertiary Care Centers*
Tertiary Healthcare*
Thrombophilia*
Antithrombin III
Factor V
Protein S

Reference

1. Practice Committee of the American Society for Reproductive Medicine. Definitions of infertility and recurrent pregnancy loss. Fertil Steril. 2008; 89:1603.

2. Fawzy M, Shokeir T, El-Tatongy M, Warda O, El-Refaiey AA, Mosbah A. Treatment options and pregnancy outcome in women with idiopathic recurrent miscarriage: a randomized placebo-controlled study. Arch Gynecol Obstet. 2008; 278:33–38.

3. Salafia CM, Minior VK, Pezzullo JC, Popek EJ, Rosenkrantz TS, Vintzileos AM. Intrauterine growth restriction in infants of less than thirty-two weeks' gestation: associated placental pathologic features. Am J Obstet Gynecol. 1995; 173:1049–1057.

4. Preston FE, Rosendaal FR, Walker ID, Briet E, Berntorp E, Conard J, et al. Increased fetal loss in women with heritable thrombophilia. Lancet. 1996; 348:913–916.

5. Alonso A, Soto I, Urgelles MF, Corte JR, Rodriguez MJ, Pinto CR. Acquired and inherited thrombophilia in women with unexplained fetal losses. Am J Obstet Gynecol. 2002; 187:1337–1342.

6. Rey E, Kahn SR, David M, Shrier I. Thrombophilic disorders and fetal loss: a meta-analysis. Lancet. 2003; 361:901–908.

7. Sarig G, Younis JS, Hoffman R, Lanir N, Blumenfeld Z, Brenner B. Thrombophilia is common in women with idiopathic pregnancy loss and is associated with late pregnancy wastage. Fertil Steril. 2002; 77:342–347.

8. Vossen CY, Preston FE, Conard J, Fontcuberta J, Makris M, van der Meer FJ, et al. Hereditary thrombophilia and fetal loss: a prospective follow-up study. J Thromb Haemost. 2004; 2:592–596.

9. Vora S, Shetty S, Ghosh K. Thrombophilic dimension of recurrent fetal loss in Indian patients. Blood Coagul Fibrinolysis. 2008; 19:581–584.

10. Sambrook J, Fritsch EF, Maniatis T. Molecular cloning: a laboratory manual. New York: Cold Spring Harbor Laboratory Press;1989.

11. Arruda VR, Annichino-Bizzacchi JM, Costa FF, Reitsma PH. Factor V Leiden (FVQ 506) is common in a Brazilian population. Am J Hematol. 1995; 49:242–243.

12. Finan RR, Tamim H, Ameen G, Sharida HE, Rashid M, Almawi WY. Prevalence of factor V G1691A (factor V-Leiden) and prothrombin G20210A gene mutations in a recurrent miscarriage population. Am J Hematol. 2002; 71:300–305.

13. Parveen F, Shukla A, Agrawal S. Should factor V Leiden mutation and prothrombin gene polymorphism testing be done in women with recurrent miscarriage from North India. Arch Gynecol Obstet. 2013; 287:375–381.

14. Biswas A, Choudhry P, Mittal A, Meena A, Ranjan R, Choudhry VP, et al. Recurrent abortions in Asian Indians: no role of factor V Leiden Hong Kong/Cambridge mutation and MTHFR polymorphism. Clin Appl Thromb Hemost. 2008; 14:102–104.

15. Hansda J, Roychowdhury J. Study of thrombophilia in recurrent pregnancy loss. J Obstet Gynaecol India. 2012; 62:536–540.