Usefulness of plasminogen activator inhibitor 4G/5G polymorphism testing in recurrent miscarriage

AUGUSTOVSKI, F; PICHON-RIVIERE A,; ALCARAZ A; BARDACH, ARIEL; FERRANTE, D; GARCIA MARTÍ, SEBASTIAN; GLUJOVSKY, D; LOPEZ, A; REGUEIRO, A

Documentos de Evaluación de Tecnologías Sanitarias

IECS

Año: 2006 p. 1 - 30

1668-2793

The purpose of this report is to assess the evidence on the clinical usefulness of plasminogen activator inhibitor 4G/5G polymorphism testing in recurrent miscarriage.Seven trials whose aim was to demonstrate the association between the PAI-1 4G/5G polymorphism and recurrent miscarriage were found. All of them used the RFLP-PCR technique. Two showed no association and one did. In the other four, association was demonstrated if the homozygotic 4G/4G combined with polycystic ovarian syndrome (two studies), deletion of the angiotensin I-converting enzyme gene or coagulation factor XIII Val34Leu polymorphism. In the study that demonstrated the association between PAI 4G/5G polymorphism and recurrent miscarriages, this was greater if associated with methylenetetrahydrofolate reductase gene C677T polymorphism. Clinical practice guidelines: Guidelines for the management of recurrent miscarriages issued by the American College of Obstetricians and Gynecologists, the Royal College of Obstetricians and Gynecologist, the Argentine Society on Reproductive Medicine and the guidelines on antithrombotic agents use during pregnancy issued by the American College of Chest Physicians (Consensus Conference on Antithrombotic Therapy and Thrombolic Therapy) were consulted. None of them mentioned the need of performing plasminogen activator inhibitor 4G/5G polymorphism testing in recurrent miscarriage. Health technology evaluations: No health technology assessment was found among the sources consulted.