Peculiarities of the Haemostatic System in Pregnant Patients with Burdened Obstetric Anamnesis
https://doi.org/10.24060/2076-3093-2018-8-2-41-45
Abstract
Introduction. A number of researchers point at a direct connection between mutations of genes affecting the haemostasis system and risks of venous thromboembolism and / or infertility. Quite often, a thrombophilia diagnosis is a result of overdiagnosis, which may lead to ungrounded and even dangerous medical prescriptions. In this context, the key goal of this work was to analyse the homeostasis system in women with recurrent pregnancy loss and establishes the causes of this phenomenon.
Materials and methods. Over the course of this work, we analysed 79 women in various stages of pregnancy who were receiving treatment in the Pregnancy Pathology Department of the BSMU Clinic. We analysed their medical histories, Body Mass Indexes (BMI), polymorphisms of haemostasis system genes and thrombosis risk factors.
Results and discussion. BMI analysis found normal body mass in 39 patients (49.4 %) and excessive body mass in 40 patients (50.6 %). F2 and F5 gene polymorphisms were almost entirely absent. ITGA2 and ITGB3 gene mutations were found in the patients analysed in 48.1 % and 17.7 % of the cases, respectively. PAI-1 gene mutations were found in 84.8 % of cases. MTR and MTRR gene polymorphisms were detected in 35.4 % and 81.0 % of the patients, respectively. MTHFR mutations were found in more than 40 % of the patients.
Conclusion. Obesity and hereditary thrombophilia are primary factors in venous thromboembolism. Body weight loss and antithrombotic therapy reduce risk obstetric complications, improving prognosis and pregnancy outcomes.
About the Authors
B. A. BakirovRussian Federation
3 Lenin st., Ufa, 450008, Russian Federation
Doctor of Medical Sciences, Associate Professor, Head of the Department of Hospital Therapy No. 2, tel.: +79177769988
I. V. Sakhautdinova
Russian Federation
3 Lenin st., Ufa, 450008, Russian Federation
Doctor of Medical Sciences, Associate Professor, Head of the Department of Obstetrics and Gynaecology No. 1, tel.: +79177585504
A. D. Maron
Russian Federation
3 Lenin st., Ufa, 450008, Russian Federation
Assistant Lecturer of the Department of Obstetrics and Gynaecology No. 1, tel.: +79170418433
References
1. 1 Momot A.P., Nikolaeva M.G. Thrombophilias in obstetrician and gynecological practice, heparin prevention. Meditsinsky sovet = Medical Council. 2017;(13):71–8 (in Russ.). DOI: 10.21518/2079- 701X-2017-13-71-78
2. 2 Sinkov S.V., Zabolotskikh I.B. Diagnosis and correction of abnormalities in hemostasis. M.: Practicheskaya meditsina, 2017. 336 p. (in Russ.)
3. 3 Karadag C., Yoldemir T., Karadag S.D., İnan C., Dolgun Z.N., Aslanova L. Obstetric outcomes of recurrent pregnancy loss patients diagnosed wıth inherited thrombophilia. Ir J Med Sci. 2017;186(3):707–13. DOI: 10.1007/s11845-017-1569-0
4. 4 Belenkov Y., Golub A.V., Popova L., Shelest E., Patrushev L., Kondratieva T., et al. The influence of thrombophilia and obesity on the risk of venous thrombosis. Klinicheskaia meditsina = Clinical Medicine. 2017;95(6):545–8 (in Russ.). DOI: 10.18821/0023-2149-2017-95-6-545-548
5. 5 Khromylev A.V. Pathogenetic aspects of atherothombotic risk in obesity and thrombophilia. Akusherstvo, ginekologiia i reprodukciia = Obstetrics, Gynecology and Reproduction. 2015;9(3):45– 52 (in Russ.). DOI: 10.17749/2070-4968.2015.9.3.045-052
6. 6 Perederyaeva E.B., Pshenichnikova T.B., Donina E.V., Makatsariya A.D., Kapanadze D.L. The course of pregnancy in women with metabolic syndrome in view of pathogenetic role of thrombophilia. Akusherstvo, ginekologiia i reprodukciia = Obstetrics, Gynecology and Reproduction. 2014;8(1):60–7 (in Russ.).
7. 7 Pavord S., Hunt B.J. (eds) The obstetric hematology manual. NY: Cambridge University Press, 2018. 346 p. DOI: 10.1017/9781316410837
8. 8 Di Nisio M., Ponzano A., Tiboni G.M., Guglielmi M.D., Rutjes A.W.S., Porreca E. Effects of multiple inherited and acquired thrombophilia on outcomes of in-vitro fertilization. Thromb Res. 2018;167:26–31. DOI: 10.1016/j.thromres.2018.05.006
9. 9 Dai A.I., Demiryürek S., Aksoy S.N., Perk P., Saygili O., Güngör K. Maternal iron deficiency anemia as a risk factor for the development of retinopathy of prematurity. Pediatr Neurol. 2015;53(2):146–50. DOI: 10.1016/j.pediatrneurol.2015.04.002
10. 10 Moin A., Lassi Z.S. Can routine screening and iron supplementation for iron deficiency anemia in nonsymptomatic pregnant women improve maternal and infant health outcomes?. J Family Med Prim Care. 2015;4(3):333–4. DOI: 10.4103/2249-4863.161310
11. 11 Tandu-Umba B., Mbangama A.M. Association of maternal anemia with other risk factors in occurrence of Great obstetrical syndromes at university clinics, Kinshasa, DR Congo. BMC Pregnancy Childbirth. 2015;15:183. DOI: 10.1186/s12884-015-0623-z
12. 12 Grinevich T.N., Lyalikov S.A., Stepuro T.L. Prediction of hypercoagulable states during pregnancy by analyzing genetic status of women with recurrent miscarriage. Zhurnal Grodnenskogo gosudarstvennogo medicinskogo universiteta = Journal of the Grodno State Medical University. 2016; (4):50–4 (in Russ.).
Review
For citations:
Bakirov B.A., Sakhautdinova I.V., Maron A.D. Peculiarities of the Haemostatic System in Pregnant Patients with Burdened Obstetric Anamnesis. Creative surgery and oncology. 2018;8(2):125-129. (In Russ.) https://doi.org/10.24060/2076-3093-2018-8-2-41-45