PROGNOSIS OF RECURRENT PREGNANCY LOSS ASSOCIATED WITH HEREDITY THROMBOPHILIA
DOI:
https://doi.org/10.11603/24116-4944.2017.1.7336Keywords:
pregnancy, miscarriage, thrombophilia, gene polymorphism, prognosis, hemostasis.Abstract
The aim of the study – to determine the prognostic significance of thrombophilia markers of endothelial dysfunction, hypertension and pathology of the folate cycle in the development of recurrent miscarriage.
Materials and methods. It was conducted a complex clinical and laboratory examination of 109 women with RM and 34 healthy pregnant women. With PCR were determined polymorphisms in the genes of factor V Leiden1691 G → A, prothrombin20210 G → A, plasminogen activator inhibitor type 1 5G / 4G, fibrinogen β455 G → A, paraoxonase-1192 Q → R, methylentetrahydrofolatereductase677 C → T and angiotensinogen235 M → T. Methods of parametric and nonparametric statistics were used.
Results of the study. Study demonstrated that the predictive value for the development of the RM is the presence of genetic defects in the hemostatic system (heterozygous mutation gene factor V Leiden 1691 GA (p <0.05, OR=5.31; 95 % DI 1.52–18.53), prothrombin 20210 GA OR=13.04; 95 % DI 1.71–99.51), homozygous PAI-1 4G / 4G abnormal gene polymorphisms (p <0.05, OR=7.57; 95% DI 1.7–33.38), fibrinogen β -455 AA (p <0.05, OR=10.87, 95% DI 1.42–83.27) -455 G→A) and folate cycle: MTHFR 677 CT ( p <0.05, OR=2.56; 95% DI 1.0–6.15) and 677 CT (p <0.05, OR=8.26; 95% DI 1.07–63).
Prognostic significance also has complicated hereditary thrombotic anamnesis, the presence of obesity and hypertension. High frequency of multigenic thrombophilia (two or more defect) has been identified in 80.7 % patients with recurrent miscarriage. The most frequently were detected pathologic polymorphisms that cause defects in fibrinolysis in combination with the disfibrinogenemy.
Conclusions. To prevent recurrence reproductive losses, in patients with a history of RM is necessary to conduct a survey for the presence of gene polymorphisms of blood coagulation and folate cycle.
References
Sidelnikova, V.M., & Sukhikh, G.T. (2010). Nevynashivanie beremennosti Miscarriage. Moskva: MIA [in Russian].
Osman, O.M. & Abulata, N.N. (2015). Inherited Thrombophilia and Early Recurrent Pregnancy Loss among Egyptian Women. Open Journal of Obstetrics and Gynecology, 5, 251–258. http://dx.doi.org/10.4236/ojog.2015.55037
Veropotvelyan, N.P. (2014). Nasledstvennyie trombofilii u zhenschin so sporadicheskimi i privyichnyimi reproduktivnymi poteryami v pervom trimestre bremennosti [Hereditary thrombophilia in women with sporadic and habitual reproductive losses in the first trimester of pregnancy]. Reproduktivnoe zdorove. Vostochnaya Evropa – Reproductive Health. Eastern Europe, 1, 64–72, [in Russian].
Ventskovskaya, I.B., & Proshchenko, O.N. (2015). Prognozirovanie nevynashivaniya beremennosti na osnove otsenki geneticheskih prediktorov [Prediction of miscarriage based on the evaluation of genetic predictors]. Reproduktivnoe zdorove. Vostochnaya Evropa – Reproductive Health. Eastern Europe, 1 (37), 27–34 [in Russian].
Baranov, V.S., Ivashchenko, T.E., & Glotov, A.S. (2009). Opredelenie nasledstvennoy predraspolozhennosti k nekotorim chastim zabolevaniyam pri beremennosti. Geneticheskaya karta reproduktivnogo zdorovya [Determining genetic predisposition to certain diseases common in pregnancy. The genetic map of reproductive health]. Sankt-Piterburg: N-L. [in Russian].
Makatsariya, A.D., & Bitsadze, V.O. (2008). Profilaktika povtornyih oslozhneniy beremennosti v usloviyah rukovodstvo dlya vrachey [Prevention of recurrent pregnancy complications in the conditions of thrombophilia: A Guide for Physicians]. Moskva: Triada-H. [in Russian].
Shamanova, M.B., Gogolevskaya, I.K., Lebedeva, E.G., & Kurtser, M.A. (2009). Rol mutatsiy v genah FII, FV i MTHFR u patsientok s privyichnyim nevyinashivaniem [The role of mutations in the genes of the FII, MTHFR and FV in patients with recurrent pregnancy loss]. Problemy reproduktsii – Problems of reproduction, 1, 104–107 [in Russian].
Cao, Y., Zhang, Z., Zheng, Y., Yuan, W., Wang, J., Liang, H., & Shen, Y. (2014). The association of idiopathic recurrent early pregnancy loss with polymorphisms in folic acid metabolism-related genes. Genes & Nutrition, 9(3), 402. http://doi.org/10.1007/s12263-014-0402-x.
Larciprete, G., Rossi, F., Deaibess, T., Brienza, L., Barbati, G., Romanini, E., … Gioia, S. (2010). Double inherited thrombophilias and adverse pregnancy outcomes: fashion or science? J. Obstet. Gynaecol. Res., 36(5), 996-1002.
Maksimov, S.A., Zinchuk, S.F., Davydova, E.A., & Zinchuk, V.G. (2010). Riski i ih otsenka v mediko-biologicheskih issledovaniyah: metod. rekomendatsii [Risks and evaluation in biomedical research: method. recommendations]. Kemerovo [in Russian].
Turchin, V.N. (2012). Teoriya veroyatnostey i matematicheskaya statistika. Osnovnyie ponyatiya, primeryi i zadachi [Theory of probability and mathematical statistics. Basic concepts, examples and exercises]. Dnepropetrovsk: IMA-PRESS [in Russian].
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish in this journal agree to the following terms:
1. The authors reserve the right to authorship of the work and pass the journal right of first publication of this work is licensed under a Creative Commons Attribution License, which allows others to freely distribute the work published with reference to the authors of the original work and the first publication of this magazine.
2. Authors are entitled to enter into a separate agreement on additional non-exclusive distribution of work in the form in which it was published in the magazine (eg work place in the electronic repository institution or publish monographs in part), provided that the reference to the first publication of this magazine.
3. Policy magazine allows and encourages authors placement on the Internet (eg, in storage facilities or on personal websites) manuscript of how to submit the manuscript to the editor and during his editorial processing, since it contributes to productive scientific discussion and positive impact on the efficiency and dynamics of citing published work (see. The Effect of Open Access).
