The Importance of Hematological Parameters in Recurrent Pregnancy Loss

Year 2019, Volume: 21 Issue: 1, 85 - 89, 30.04.2019

Mahmut İlkin Yeral , Buğra Coşkun , Bora Coşkun , Fatih Karslı Coşkun Cimşir

https://doi.org/10.24938/kutfd.524640

Abstract

Objective:
We aimed to investigate hematological parameter changes in recurrent pregnancy
loss patients.

Material and Method: Two-hundred and fifty-two patients with at least two
abortions admitted to our clinic were included in the study. Patients in Group 1 (n=198) had two consecutive pregnancy losses
whereas patients in Group 2 (n=54) had at least three consecutive pregnancy
losses. Demographic data and hematological parameters were evaluated
retrospectively.

Results: When the demographic data were compared,
there was no statistically significant difference between the mean ages of
groups (p=0.069). In terms of body mass index, gravida, parity, number of
living children, there was a statistically significant difference between the
two groups and Group 2 was significantly higher than Group 1 (p<0.05). The
anticardiolipin antibody IgM and IgG values of Group 2 was significantly higher
than the values of Group 1 (p<0.05). In terms of APTT, PT, INR, fibrinogen,
active protein-C resistance, antithrombin-3, protein C, protein S values, there
was no statistically significant difference between the groups (p>0.05).

Conclusion: It has been concluded
that antiphospholipid antibody screening will be a cost-effective and effective
approach in patients with recurrent pregnancy loss.

Keywords

Recurrent pregnancy loss, anticardiolipin antibody, antiphospholipid syndrome

TEKRARLAYAN GEBELİK KAYBINDA HEMATOLOJİK PARAMETRELERİN ÖNEMİ

Abstract

Amaç: Tekrarlayan
gebelik kaybı hastalarında hematolojik parametre değişikliklerini incelemeyi
hedefledik.

Gereç ve Yöntem:
Kliniğimize
başvuran ardışık en az iki düşük yapmış 252 hasta çalışmaya dahil edildi. Ardışık
iki düşük yapan hastalar 1. grup (n=198), üç ve üstü
düşük yapan hastalar ise 2. grup (n=54) olarak isimlendirildi. Hastaların yatış
dosyasındaki demografik veriler ve hematolojik parametreler retrospektif olarak
incelendi.

Bulgular: Demografik veriler karşılaştırıldığında;
grupların yaş ortalamaları arasında istatistiksel olarak anlamlı bir fark
saptanmadı (p=0.069). Vücut kütle indeksi, gravida, parite, yaşayan çocuk
sayısı bakımından ise iki grup arasında istatistiksel olarak anlamlı fark
saptandı ve 2. grupta daha yüksekti (p<0.05). Laboratuvar parametrelerinde
ise; 2. grupta antikardiolipin IgM ve IgG değerleri istatistiksel olarak
anlamlı derecede yüksek saptandı (p<0.05). APTT, PT, INR, fibrinojen, aktive
protein-C rezistansı, antitrombin-3, protein C, protein S değerleri bakımından
iki grup arasında istatistiksel olarak anlamlı fark saptanmadı (p>0.05).

Sonuç: Tekrarlayan gebelik kaybı olan hastalarda antifosfolipid antikor
taramanın, düşük maliyetli ve etkili bir yaklaşım olacağı sonucuna varılmıştır.

Keywords

Tekrarlayan gebelik kaybı, antikardiolipin antikor, antifosfolipid sendrom

References

• 1. Ford HB, Schust DJ. Recurrent pregnancy loss: etiology, diagnosis, and therapy. Rev Obstet Gynecol. 2009;2(2):76-83.
• 2. Ingrid Pabinger. Thrombophilia and its impact on pregnancy. Thrombosis Researh. 2009;123(Suppl 3):S16-21.
• 3. Duckitt K, Qureshi A. Recurrent miscarriage. Am Fam Physician. 2008;78(8):977-8.
• 4. Practice Committee of American Society for Reproductive Medicine. Definitions of infertility and recurrent pregnancy loss. Fertil Steril. 2013;99(1):63.
• 5. Jauniaux E, Farquharson RG, Christiansen OB, Exalto N. Evidence-based guidelines for the investigation and medical treatment of recurrent mis¬carriage. Hum Reprod. 2006;21(9):2216-22.
• 6. Christiansen OB, Nybo Andersen AM, Bosch E Daya S, Delves PJ, Hviid TV, Kutteh WH et al. Evidence based inves¬tigations and treatments of recurrent pregnancy loss. Fertil Steril. 2005;83(4):821-39.
• 7. Poland BJ, Miller JR, Jones DC, Trimble BK. Reproductive counseling in patients who have had a spontaneous abortion. Am J Obstet Gynecol. 1977;127(7):685-91.
• 8. Özdemir S, Balcı O, Göktepe H, Görkemli H, Taşçı E, Acar H. Tekrarlayan gebelik kaybı olan hastalarda trombofili mutasyon sıklığının değerlendirilmesi. Genel Tıp Derg. 2010;20(3):93-7.
• 9. Barut MU, Bozkurt M, Kahraman M, Yıldırım E, Imirzalioğlu N, Kubar A et al. Thrombophilia and recurrent pregnancy loss: The enigma continues. Med Sci Monit. 2018;24:4288-94.
• 10. Merrill JT. Which antiphospholipid antibody tests are most useful? Rheum Dis Clin North Am. 2001;27(3):525-49.
• 11. Levine JS, Branch DW, Rauch J. The Antiphospholipid Syndrome. N Engl J Med. 2002;346(10):752-63.
• 12. Di Simone N, Castellani R, Caliandro D, Caruso A. Antiphospholid antibodies regulate the expression of trophoblast cell adhesion molecules. Fertil Steril. 2002;77(4):805-11.
• 13. Isom R, Nickolas TL, Radhakrishnan J. Nephrological and obstetric complications of the antiphospholipid syndrome. Expert Opin Investig Drugs. 2002;11(6):819-29.
• 14. Geis W, Branch DW. Obstetric implications of antiphospholipid antibodies: pregnancy loss and other complications. Clin Obstet Gynecol. 2001;44(1):2-10.
• 15. Valesini G, Pittoni V. Treatment of thrombosis associated with immunological risk factors. Ann Med. 2000;32(Suppl 1):41-45.
• 16. Petri M. Management of thrombosis in antiphospholipid antibody syndrome. Rheum Dis Clin North Am. 2001;27(3):633-42.