Deep venous thrombosis in the antenatal period in a large cohort of pregnancies from western India

被引：21
作者：
Vora S. [1 ]
Ghosh K. [1 ]
Shetty S. [1 ]
Salvi V. [2 ]
Satoskar P. [3 ]
机构：
[1] Department of Haemostasis, Institute of Immunohaematology (ICMR), KEM Hospital, Parel
[2] Department of Obstetrics and Gynaecology, KEM Hospital, Parel
[3] Dept. of Obstetrics and Gynaecology, Nowrosjee Wadia Maternity Hospital, Parel
来源：
Thrombosis Journal | / 5卷 / 1期
关键词：
Deep Venous Thrombosis; Thrombophilia; G20210A Polymorphism; Cerebral Venous Thrombosis; MTHFR C677T;
D O I：
10.1186/1477-9560-5-9
中图分类号：
学科分类号：
摘要：
Background: Deep venous thrombosis (DVT) is an important complication in the peripartal and postpartal period. Methods: We followed up prospectively the prevalence of DVT in 34720 prenatal mothers between June 2002 and July 2006 attending the antenatal clinics of two major hospitals in Mumbai, India. Thirty two women (0.1%) presented for the first time with symptomatic DVT i.e. 17 in the first trimester, 6 in the second and 9 in the third trimester of pregnancy. Nine had history of fetal loss while in the remaining twenty three there was no history of fetal loss. Results: The evaluation of both acquired and heritable thrombophilia showed a conglomeration of thrombophilia in this group when compared to 100 normal pregnant women who have given birth to at least one healthy baby with no history of fetal death, DVT or other obstetrical complications. The relative risks for all the antiphospholipid antibodies (APA) studied i.e lupus anticoagulant (LA), IgG/IgM antibodies for cardiolipin (ACA), β2 glycoprotein 1 (β2 GP 1) and annexin V were significantly higher in women with pregnancy associated DVT (RR 7.4 95% CI 4.3-11.3 P < 0.05). Among the genetic thrombophilia markers studied, Protein S (PS) deficiency was the strongest risk factor (RR 5.00 95% CI 3.02-5.00 P < 0.05) followed by factor V Leiden (FVL) mutation (RR 4.57 95% CI 2.23-4.57 P < 0.05) and PAI 4G/4G homozygosity (RR 3.24 95% CI 1.85-5.12 P < 0.05). Protein C (PC) and endothelial protein C receptor (EPCR) 23 bp insertion polymorphism was also increased in the patient group as compared to controls but the difference was not statistically significant. The MTHFR C677T, fibrinogen gene β448 Arg/Lys polymorphisms were not significantly different from the normal controls, while antithrombin III (AT III) deficiency and PT G20210A polymorphism were absent in both controls and patients. Two or more risk factors were present in 22 out of 32 cases (68.75%). Conclusion: We conclude that the prevalence of DVT in India is more or less similar to other reports published and both acquired and heritable thrombophilia show strong association with DVT associated with pregnancy. © 2007 Vora et al; licensee BioMed Central Ltd.
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  • [1] Prevalence of venous thrombosis and embolism, JAMA, 256, pp. 744-749, (1986)
  • [2] Greer I.A., Haemostasis and Thrombosis in Pregnancy. Haemostasis and Thrombosis, 2, pp. 987-1015, (1994)
  • [3] Bonnar J., Hemostasis and Coagulation Disorders in Pregnancy. Hemostasis and Thrombosis, pp. 570-584, (1987)
  • [4] Uszynski M., Maciejewski K., Uszynski W., Kuczynski J., Placenta and myometrium - The two main sources of fibrinolytic components during pregnancy, Gynaecol Obstet Invest, 52, pp. 189-193, (2001)
  • [5] Simpson E.L., Lawrenson R.A., Nightingale A.L., Farmer R.D., Venous thromboembolism in pregnancy and puerperium: Incidence and additional risk factors from a London perinatal database, Brit J Obstet Gynaecol, 108, pp. 56-60, (2001)
  • [6] Andersen B.S., Srefensen F.H., Sorensen H.T., Nielsen G.L., Olsen J., The cumulative incidence of venous thromboembolism during pregnancy and puerperium - A 11 year Danish population based study of 63,300 pregnancies, Acta Obstet Gynaecol Scand, 77, pp. 170-173, (1998)
  • [7] Dindagur N., Kruthika-Vinod T.P., Christopher R., Factor V gene A4070G mutation and the risk of cerebral veno-sinus thrombosis occurring during puerperium, Thromb Re, 119, pp. 497-500, (2007)
  • [8] Brandt J.T., Triplett D.A., Alving B., Scharrer I., Criteria for the diagnosis of lupus anticoagulants: An update, on behalf of the sub committee on lupus anticoagulant/antiphospholipid antibody of the scientific and standardization committee of the ISTH, Thromb Haemost, 74, pp. 1185-1190, (1995)
  • [9] Manniatis T., Fritsch, Sambrook J., Molecular Cloning: A Laboratory Manual
  • [10] Arruda V.R., Annichma-Bizzaahi J.M., Costa F.F., Reitsma P.H., Factor V Leiden (FVQ506) is common in a Brazilian population, Am J Haematol, 49, pp. 242-243, (1995)
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