الفهرس 
الملخص العربي
Haemostatie McchanismsOnly 14 pages are availabe for public view
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Abstract
This study was done in the Departments of Clinical Pathology and Obstetrics and Gynecology, Assiut University Hospital, Assiut, Egypt, in the period between March 2006 and February 2008 and included 40 pregnant women; with their ages ranged from 18 to 38 years who had unexplained recurrent early pregnancy loss and 44 age-matched pregnant women without a history of recurrent fetal loss and have normal menstrual cycle as control group. All women agreed to participate in the study and ethical approval was granted from the Local Research Ethics Committee.
The purpose of this study was to evaluate the haemostatic changes in the women with unexplained recurrent early pregnancy loss and its association with recurrent pregnancy loss.
All study and control groups were subjected to a thorough clinical history and were examined by gynecologist.
Inclusion Criteria were: Age (18– 38 years), gestational age (12-18 weeks) and history of recurrent early pregnancy loss (three or more consecutive fetal loss before 20 weeks of gestation).
Exclusion Criteria were:
• Metabolic abnormalities (e.g., Diabetes mellitus, Liver diseases).
• Immunological abnormalities (e.g., Thyroid dysfunction, Rheumatoid arthritis, Hashimoto, s thyroiditis).
• Endocrine abnormalities (e. g., luteal insufficiency).
• Thrombophilic abnormality (e.g., Deep Venous Thrombosis, Ischemic heart disease).
• Anatomical abnormalities (e.g., uterine defects such as septate, bicornuate, uteri. and incompetence cervix).
• Multiple pregnancy
• History of fetal congenital anomalies.
• History of consanguinity.
• History of drug intake that may affect haemostasis (e.g., Heparin, warfarin, aspirin).
• Hormonal therapy (e.g., steroid, estrogen).
All women were subjected to the following:
Ultrasound examination.
Routine investigations: complete blood count, blood groups & Rh typing, liver function tests, kidney function tests, random blood glucose, prothrombin time and activated partial thromboplastin time.
Specific investigations: antithrombin III, protein C activity, protein C antigen, protein S, anticardiolipin (IgM, IgG) and lupus anticoagulant
The following results were obtained:
The CBC parameters (Hb., Hct, RBCs, Platelets) showed no significant changes in the cases than the control group. WBC showed insignificant increase and still within reference range.
The blood groups in the controls: O+ (38.6%), A+ (29.5%), B+ (18.2%), AB+ (9.1%), O- negative (2.3%) and A- negative (2.3%)., while in the cases were: O+ (40%), A+ (25%), B+ (22.5%), AB+ (7.5%) and A- negative (5%).
Liver Function Tests:
The liver function tests (total protein, bilirubin, albumin, and enzymes) showed insignificant differences in the cases compared with the control group, and still within the reference range.
Kidney Function Tests:
Both blood urea level and serum creatinine showed non-significant differences between the cases and control, but still within the reference range.
Random blood Glucose:
No significantly differences were observed between the cases and the controls.
Prothrombin Time:
The prothrombin time in the control group ranged from 12 sec. to 14.4 sec. with mean ± SD (12.6 ± 0.8) sec., while its range in the cases was from 10 sec to 16.1 sec with mean ± SD (13.0 ± 1.1) sec. There is no significant difference in the cases compared with the controls.
Activated Partial Thromboplastin Time (aPTT):
The mean of aPTT was significantly prolonged in the cases compared with the control. In the cases it ranged from 32 sec. to 48 sec, with mean ± SD (37.9 ± 9.9) sec, while its range in the control group was from 29 sec. to 36 sec. with mean ± SD (32.2 ± 3.2) sec.
Antithrombin III:
There is a significant decrease in the antithrombin III among the cases compared with control group. It ranged in the cases from 38% to 123% with the mean ± SD (79.5 ± 20.6)%, while in the control group it ranged from 49% to 135%, with mean ± SD (96.8 ± 21.2)%.
Protein C (activity & antigen):
There is mild decrease in the level of protein C antigen among the cases compared with the control group. In the cases it ranged from 30% to 160% with mean ± SD (116.9 ± 30)%, while its range in the control group was from 70% to 175% with mean ± SD (124.9 ± 29.9)%. The incidence of deficiency was 7.5% in the cases versus 2.3% in the controls but without statistical significance.
The activity of protein C in the cases was from 30% to 128% with mean ± SD (91.9 ± 23.5) % less than control group in which ranged from 65% to 130% with mean ± SD (93.8 ± 22.2)%. The incidence of deficiency in the cases was 10%; the difference was not statistically significant.
Protein S:
There is statistically significant decrease in protein S among the cases; it ranged from 17% to 77% with mean ± SD (40.3 ± 14.9)%, while its range in the control was from 35% to 132% with mean ± SD (50 ± 16.1)%. The incidence of deficiency was 37% in the cases versus 14% in the control.
Anticardiolipin (IgG):
In the control group 6 women out of 44 (14%) were positive with anticardiolipin IgG, in other hand there were 13 cases out of 40 (32%) positive with IgG. The incidence in the cases was markedly statistically significant than controls.
Anticardiolipin (IgM):
All women in the control group were negative for anticardiolipin IgM, while 4 cases out of 40 (10%) were positive with IgM in the cases. The incidence in the cases was markedly statistically significant than control.
Lupus Anticoagulants:
In the control group 7 women out of 44 (16%) were positive for LA while 18 cases out of 40 (45%) were positive for LA in the cases group.
The positivity in the cases was very high statistically significant than controls.