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Hypercoagulable state mutation analysis in white patients with early first-trimester recurrent pregnancy loss
W H Kutteh1, V M Park, S R Deitcher
1Department of Obstetrics and Gynecology, The University of Tennessee, Memphis 38163-2116, USA.
Objective:
Antiphospholipid antibodies (APA) and other coagulation abnormalities have been associated with an increased risk of venous, arterial, and placental thrombosis and recurrent pregnancy loss (RPL). Factor V Leiden (a point mutation [1691G-->A] in the factor V gene), the prothrombin 20210G-->A mutation, and homozygosity for a common polymorphism in the methylene tetrahydrofolate reductase (MTHFR) gene (677C-->T) have been associated with arterial and venous thrombosis and arterial occlusive disease. We explored an association between these markers of thrombophilic states and RPL.
Design:
Prospective case-control evaluation.
Setting:
University-associated private practice.
Patient(S):
Fifty nonpregnant women with three or more pregnancy losses and 50 healthy, nonpregnant controls.
Intervention(S):
None.
Main Outcome Measure(S):
Anticardiolipin and antiphosphatidylserine antibodies were detected in serum by ELISA. Polymerase chain reaction was performed to identify the factor V Leiden (1691G-->A) mutation, the thermobile MTHFR (677C-->T) mutation, and the prothrombin 20210G-->A mutation.
Result(S):
The following were identified by restriction fragment-linked polymorphism analyses: 1 (2%) factor V Leiden heterozygosity; 1 (2%) prothrombin 20210G-->A heterozygosity; and 4 (8%) thermolabile MTHFR homozygosity. None of these mutation frequencies in women with RPL were statistically significantly different from controls.
Conclusion(S):
These data suggest that factor V Leiden, thermolabile MTHFR (677C-->T), and prothrombin 20210G-->A are not found at an increased frequency in women with a history of early RPL.
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