Dehkordi Maryam Al-E-Rasul, Soleimani Akbar, Haji-Gholami Ali, Vardanjani Abdolrahim Kazemi, Dehkordi Saeid Al-E-Rasul
Department of Gynecology and Obstetrics, Shahrekord University of Medical Sciences, Shahrekord, Iran.
Department of Internal Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran.
Int J Hematol Oncol Stem Cell Res. 2014 Oct 1;8(4):5-11.
Thrombophilia is a pathological state of increased blood coagulability. It causes problems during pregnancy including preeclampsia, stillbirth, repeated abortions, and detached pair. Out of the most prevalent factors causing inherited thrombophilia, protein S (Prs), protein C (Prc), and antithrombin III (ATIII) deficiency, and Factor V Leiden (FVL) mutation could be mentioned. This study aimed to investigate association of these parameters with preeclampsia.
In this case-control study, 142 pregnant women with preeclampsia referred to Obstetric Clinic of Hajar Hospital, southwest of Iran, were assigned to the case group after clinical laboratory tests and according to specialist point of view and 142 pregnant women with normal blood pressure were assigned to the control group. After obtaining consent and completing relevant questionnaire, a 4-cc blood sample was taken from the patients. Coagulation factors and FVL rate were measured and after 6 months patients were followed- up. Data analysis was done by SPSS software using t-test.
In view of deficiency of Prs, Prc, and ATIII, no statistically significant association was observed between case and control groups (P>0.05). Statistical t-test indicated that the rate of FVL deficiency in pregnant patients with preeclampsia was significantly different from that in the control group (p=0.03). In addition, the body mass index of case group was significantly higher than that of control group prior to pregnancy (P=0.001). In case group, preeclampsia history contributed to development of current preeclampsia in contrast to control group (p<0.001). The patients of case group were followed up after 6 months in view of blood pressure and all had a normal mean blood pressure at the completion of the study.
Measurement of FVL deficiency could help to decrease the unpleasant complications of vascular disorders during pregnancy. But, screening test for pre-eclampsia does not seem necessary to determine the deficiency of coagulation factors, Prs, Prc, and ATIII.
易栓症是一种血液凝固性增加的病理状态。它会在孕期引发问题,包括先兆子痫、死产、反复流产和胎盘早剥。在导致遗传性易栓症的最常见因素中,可以提及蛋白S(Prs)、蛋白C(Prc)和抗凝血酶III(ATIII)缺乏以及凝血因子V莱顿(FVL)突变。本研究旨在调查这些参数与先兆子痫之间的关联。
在这项病例对照研究中,142名转诊至伊朗西南部哈贾尔医院产科门诊的先兆子痫孕妇,经临床实验室检查并根据专家意见被归入病例组,142名血压正常的孕妇被归入对照组。在获得患者同意并完成相关问卷后,从患者身上采集4毫升血液样本。测量凝血因子和FVL率,并在6个月后对患者进行随访。使用SPSS软件通过t检验进行数据分析。
鉴于Prs、Prc和ATIII缺乏,病例组和对照组之间未观察到统计学上的显著关联(P>0.05)。统计学t检验表明,先兆子痫孕妇中FVL缺乏率与对照组有显著差异(p=0.03)。此外,病例组的体重指数在孕前显著高于对照组(P=0.001)。与对照组相比,病例组中有先兆子痫病史会促使当前先兆子痫的发生(p<0.001)。鉴于血压情况,对病例组患者在6个月后进行了随访,在研究结束时所有患者的平均血压均正常。
检测FVL缺乏有助于减少孕期血管疾病的不良并发症。但是,对于先兆子痫,似乎没有必要进行筛查试验来确定凝血因子Prs、Prc和ATIII的缺乏情况。