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Recurrent Pregnancy Loss and Thrombophilia: An insight

Mudasir Maqbool, Irfat Ara, Mehrukh Zehravi, Imran Gani

Abstract


By definition, thrombophilia refers to acquired and/or hereditary diseases that predispose people to venous and arterial thromboembolic events. The most common cause of death on the planet is thrombosis. Myocardial infarction and stroke are major causes of morbidity and mortality in the vascular system. The deep veins of the lower extremity are the most usually involved in venous thromboembolic events, which can lead to pulmonary emboli. Thromboembolism is the major cause of antepartum and postpartum maternal mortality, as pregnancy is a hypercoagulable state. Recurrent Pregnancy Loss (RPL) is a major public health issue, with about 15-20 percent of all clinically diagnosed pregnancies ending in a miscarriage. RPL affects about 1% to 2% of women and is defined as three successive pregnancy losses before 20 weeks. Patients' lives are severely impacted by recurrent pregnancy loss. Each miscarriage leaves you feeling bereft and bewildered. The link between thrombophilia and recurrent pregnancy loss (RPL) has been shown beyond a shadow of a doubt. The physiologic changes of pregnancy, which create a relative hypercoagulable condition, as well as physical alterations that contribute to greater stasis, and the impact of both inherited and acquired thrombophilias, all play a role in the development of thrombosis in pregnancy. The importance of each of these factors in the development of thrombophilia is discussed in this review, as well as the evidence regarding the influence of pregnancy-related thrombosis on pregnancy outcomes.

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References


Khan S, Dickerman JD. Hereditary thrombophilia. Thrombosis journal. 2006 Dec;4(1):1-7.

Reznikoff-Etiévant, M., et al., Factor V Leiden and G20210A prothrombin mutations are risk factors for very early recurrent miscarriage. British Journal of Obstetrics and Gynaecology, 2001. 108(12): p. 1251-1254.

Maqbool, M., et al., Animal models in diabetes mellitus: an overview. Journal of Drug Delivery and Therapeutics, 2019. 9(1-s): p. 472-475.

Benedetto, C., et al., Coagulation disorders in pregnancy: acquired and inherited thrombophilias. Annals of the New York Academy of Sciences, 2010. 1205(1): p. 106-117.

Kujovich, J.L., Factor v Leiden thrombophilia. Genetics in Medicine, 2011. 13(1): p. 1-16.

Battinelli, E.M., A. Marshall, and J.M. Connors, The role of thrombophilia in pregnancy. Thrombosis, 2013. 2013.

Maqbool, M., I. Gani, and M.A. Dar, Anti-diabetic effects of some medicinal plants in experimental animals: a review. Asian Journal of Pharmaceutical Research and Development, 2019. 7(1): p. 66-69.

Varga, E.A. and S. Moll, Prothrombin 20210 mutation (factor II mutation). Circulation, 2004. 110(3): p. e15-e18.

Maqbool, M., et al., Herbal medicines as an alternative source of therapy: a review. World Journal of Pharmacy and Pharmaceutical Sciences, 2019. 3(2): p. 374-380.

Poort, S.R., et al., A common genetic variation in the 3'-untranslated region of the prothrombin gene is associated with elevated plasma prothrombin levels and an increase in venous thrombosis. 1996.

Li, W., Stress and Recurrent Miscarriage. 2010, University of Sheffield.

Babker, A.M.A.A.A. and F.E.M.H. Gameel, Molecular Characterization of Prothrombin G20210A gene Mutations In pregnant Sudanese women with spontaneous recurrent abortions. Rawal Medical Journal, 2015. 40(2): p. 207-209.

van Mens, T.E., M. Levi, and S. Middeldorp, Evolution of factor V Leiden. Thrombosis and haemostasis, 2013. 110(07): p. 23-30.

Robertson, L., et al., Thrombophilia in pregnancy: a systematic review. British journal of haematology, 2006. 132(2): p. 171-196.

Rodger, M., et al., Erratum: Inherited thrombophilia and pregnancy complications revisited (Obstetrics & Gynecology (2008) 112 (320-324)). Obstetrics and Gynecology, 2008. 112(6).

Forges, T., et al., Impact of folate and homocysteine metabolism on human reproductive health. Human reproduction update, 2007. 13(3): p. 225-238.

Altomare, I., A. Adler, and L.M. Aledort, The 5, 10 methylenetetrahydrofolate reductase C677T mutation and risk of fetal loss: a case series and review of the literature. Thrombosis Journal, 2007. 5(1): p. 1-4.

Foka, Z., et al., Factor V Leiden and prothrombin G20210A mutations, but not methylenetetrahydrofolate reductase C677T, are associated with recurrent miscarriages. Human Reproduction, 2000. 15(2): p. 458-462.

Mtiraoui, N., et al., Methylenetetrahydrofolate reductase C677T and A1298C polymorphism and changes in homocysteine concentrations in women with idiopathic recurrent pregnancy losses. Reproduction, 2006. 131(2): p. 395-401.

Spiroski, I., et al., Association of methylenetetrahydrofolate reductase (MTHFR-677 and MTHFR-1298) genetic polymorphisms with occlusive artery disease and deep venous thrombosis in Macedonians. Croatian medical journal, 2008. 49(1): p. 39-49.

Inomo, A., et al., The antigenic binding sites of autoantibodies to factor XII in patients with recurrent pregnancy losses. Thrombosis and haemostasis, 2008. 99(02): p. 316-323.

Ozgu-Erdinc, A.S., et al., Factor XII (Hageman) levels in women with recurrent pregnancy loss. Journal of pregnancy, 2014. 2014.

Mariano, M.-L., et al., Coagulation factor XII congenital deficiency in women with recurrent miscarriage. 2011.

Dahlbäck, B., Advances in understanding pathogenic mechanisms of thrombophilic disorders. Blood, The Journal of the American Society of Hematology, 2008. 112(1): p. 19-27.

Folkeringa, N., et al., High risk of pregnancy-related venous thromboembolism in women with multiple thrombophilic defects. British journal of haematology, 2007. 138(1): p. 110-116.

Patnaik, M.M. and S. Moll, Inherited antithrombin deficiency: a review. Haemophilia, 2008. 14(6): p. 1229-1239.

Rodgers, G.M., Role of antithrombin concentrate in treatment of hereditary antithrombin deficiency. Thrombosis and haemostasis, 2009. 101(05): p. 806-812.

Dossenbach-Glaninger, A., et al., ACE I/D polymorphism and recurrent first trimester pregnancy loss: interaction with SERPINE1 4G/5G and F13 Val34Leu polymorphisms. British journal of haematology, 2008. 141(2): p. 269-271.

George, D. and D. Erkan, Antiphospholipid syndrome. Progress in cardiovascular diseases, 2009. 52(2): p. 115-125.

Bennett, S.A., C.N. Bagot, and R. Arya, Pregnancy loss and thrombophilia: the elusive link. British journal of haematology, 2012. 157(5): p. 529-542.

Nelen, W.L., et al., Hyperhomocysteinemia and recurrent early pregnancy loss: a meta-analysis. Fertility and sterility, 2000. 74(6): p. 1196-1199.

Sedano-Balbás, S., et al., Acquired activated protein C resistance, thrombophilia and adverse pregnancy outcomes: a study performed in an Irish cohort of pregnant women. Journal of pregnancy, 2011. 2011.

Suzumori, N., et al., A case of microangiopathic antiphospholipid-associated syndromes during pregnancy: review of the literature. Case reports in medicine, 2012. 2012.

Ruiz-Irastorza, G., et al., Antiphospholipid syndrome. The Lancet, 2010. 376(9751): p. 1498-1509.

Di Prima, F.A., et al., Antiphospholipid Syndrome during pregnancy: the state of the art. Journal of prenatal medicine, 2011. 5(2): p. 41.


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