CLINICAL FINDINGS IN A PROSPECTIVE COHORT OF WOMEN IN CHILDBEARING AGE WITH THROMBOSIS AND/OR PREGNANCY ADVERSE OUTCOMES

SÁNCHEZ LUCEROS A; MESCHENGIESER SS; GROSSO SH; BLANCO AN; INGRATTI M; ALBERTO MF; LAZZARI MA

Liverpool

Congreso; 58th Annual Meeting of the Scientific and Standardization Committee of the ISTH; 2012

International Society on Thrombosis and Haemostasis

  Objectives: Thrombophilic (TF) disorders have increased their role in women´s health, presenting such as thrombotic events as pregnancies failures too. We evaluated prospectively childbearing age women with thrombosis and/or pregnancy adverse outcomes to determine the frequency of TF and the relationship to clinical findings. Methods: 357 women (mean age 34.6) (Jan-Dec 2010) were consecutively included (N): Group 1: arterial (37) and venous (56) thrombosis; Group 2: a- early recurrent miscarriage (60); b- 1 or more unexplained fetal deaths at or beyond the 10th week of gestation (126); c- 1 or more premature births before the 34th weeks (2) and/or intrauterine fetal death (57), because severe preeclampsia/placental insufficiency (20). Acquired and genetic TF screening was performed: antiphospholipid antibodies (APA) (lupus anticoagulant-LA, SSC-ISTH, IGG/IGM anti-cardiolipin antibodies-ACL), Protein S, Protein C, Antithrombin, polymorphism of IIG20210A (Prot), factor V Leiden (FVL). Venous occlusion test (VOT) (euglobulin clot lysis time) was done in Group 2. APA was confirmed to diagnosis Antiphospholipid Syndrome (APS). Details about obstetric and thrombotic history were analyzed Results: Results are described in Table. All FVL and Prot patients were heterozygous. LA* and ACL* refers to transient positive. Group 1                   Normal     APS      LA     ACL     FVL/Prot     PC/PS     Hypofibrinolysis Arterial   Stroke          19           7                                      1 / 0                 Others           0            9                                      1 / 0 Venous   PE                 5             3                                      0 /  1                 DVT             21            8                                      3 / 0          1 / 2                 Inusual         8             4        Group 2 a-                                   34          11         4         3               0 / 1          1 / 0                          7 b-                                  70           17         9         4              2 / 3                                           21 c-                                   51           8           5        4              5 / 3                                             1 Conclusion: There was no difference in the frequency of predisposing factors in TF vs. non-TF patients (p= ns) in Group 1, being hormones the most frequent one (41.3%). APS diagnosis is frequently associated to arterial and venous thrombosis in young women, regardless the presence of precipitating factors. In obstetric adverse outcome, the frequency of every TF disorder depends on obstetric history. However, FVL and Prot frequencies in this cohort were similar to our general population. Reach the World Travel Grant. http://www.ssc2012.org/Awards_and_Grants_2012.pdf http://www.ssc2012.org/Awards_and_Grants_2012.pdf http://www.ssc2012.org/Awards_and_Grants_2012.pdf http://www.ssc2012.org/Awards_and_Grants_2012.pdf