Karateke Ates, Haliloglu Berna, Gurbuz Ayse
Department of Obstetrics and Gynecology, Zeynep Kamil Women's and Children's Hospital, Istanbul, Turkey.
J Matern Fetal Neonatal Med. 2005 Nov;18(5):299-304. doi: 10.1080/14767050500381354.
To determine the role of factor V Leiden and prothrombin gene mutation in the pathogenesis of unexplained second and third trimester nonrecurrent fetal loss.
One hundred and fourteen women with unexplained nonrecurrent late fetal loss made up the study group, and 106 normal pregnant women with a history of delivery of at least one healthy fetus and no history of late fetal loss made up the control group. The study group was further divided into two subgroups: second (n = 36) and third (n = 78) trimester fetal loss. All women were tested for factor V Leiden and G20210A prothrombin gene mutations.
Twenty-one (18.4%) of the women in the study group and seven (6.6%) of the women in the control group were heterozygous carriers of factor V Leiden mutation (OR = 3.19). Eleven (9.6%) of the women in the study group and three (2.8%) of the women in the control group were heterozygous carriers of prothrombin gene mutation (OR = 3.66). In assessing with regard to trimesters, 18 (23%) factor V Leiden and 10 (12.8%) prothrombin gene mutations were present in the group of third trimester fetal loss (OR = 4.24 and OR = 5.04, respectively). Three (8.3%) factor V Leiden and one (2.7%) prothrombin gene mutation were detected in women with second trimester fetal loss (OR = 1.28 and OR = 0.40, respectively).
Factor V Leiden and prothrombin gene mutations were associated with third trimester nonrecurrent fetal loss. These mutations should be screened in women with third trimester but not second trimester unexplained nonrecurrent late fetal loss.
确定凝血因子V莱顿突变和凝血酶原基因突变在不明原因的孕中期和孕晚期非复发性胎儿丢失发病机制中的作用。
114例不明原因非复发性晚期胎儿丢失的妇女组成研究组,106例有至少一次健康胎儿分娩史且无晚期胎儿丢失史的正常孕妇组成对照组。研究组进一步分为两个亚组:孕中期(n = 36)和孕晚期(n = 78)胎儿丢失。所有妇女均检测凝血因子V莱顿突变和G20210A凝血酶原基因突变。
研究组中21例(18.4%)妇女和对照组中7例(6.6%)妇女为凝血因子V莱顿突变杂合携带者(比值比=3.19)。研究组中11例(9.6%)妇女和对照组中3例(2.8%)妇女为凝血酶原基因突变杂合携带者(比值比=3.66)。在按孕期评估时,孕晚期胎儿丢失组中有18例(23%)凝血因子V莱顿突变和10例(12.8%)凝血酶原基因突变(比值比分别为4.24和5.04)。孕中期胎儿丢失的妇女中检测到3例(8.3%)凝血因子V莱顿突变和1例(2.7%)凝血酶原基因突变(比值比分别为1.28和0.40)。
凝血因子V莱顿突变和凝血酶原基因突变与孕晚期非复发性胎儿丢失有关。对于孕晚期而非孕中期不明原因非复发性晚期胎儿丢失的妇女,应进行这些突变的筛查。