Calibrated Automated Thrombogram During Pregnancy in Unexplained Recurrent Miscarriages: A Pilot Study

Area of Science:

• Reproductive Medicine
• Hematology
• Thrombophilia Diagnostics

Background:

• Recurrent miscarriage is linked to a high incidence of thrombophilia.
• Calibrated automated thrombogram (CAT) offers a universal method for thrombophilia screening.

Purpose of the Study:

• To assess if thrombin generation, measured by CAT, is elevated in the first trimester of pregnancy for women experiencing unexplained recurrent miscarriages.
• To determine the predictive value of CAT parameters for pregnancy outcomes in this cohort.

Main Methods:

• The study included 25 pregnant women with a history of recurrent pregnancy loss undergoing thrombophilia screening and treatment with low-molecular-weight heparin (LMWH).
• Thrombin generation was analyzed using CAT in relation to miscarriage or live birth and thrombophilia status.

Main Results:

• Pregnancy outcomes included 76% live births and 24% miscarriages; 76% of women tested positive for thrombophilia.
• No significant differences in thrombin generation parameters were observed between pregnancies ending in miscarriage versus live birth.
• CAT parameters did not successfully predict pregnancy outcomes and showed only a non-significant trend toward hypercoagulability in thrombophilic women.

Conclusions:

• Thrombin generation in the first trimester was similar among women with unexplained pregnancy loss, irrespective of the pregnancy outcome.
• CAT parameters were ineffective in predicting pregnancy outcomes in women with recurrent unexplained pregnancy loss.
• Study findings should be considered preliminary due to the small sample size.