Thrombophilie als mögliche Ursache für vorzeitige Plazentalösung
Subject of the study was the analysis of a possible correlation between placental abruption and thrombophilia. 56 women of Caucasian origin in the age-bracket of 20 to 41 years participated in the study. The 56 women were treated in the gynaecological department of the RWTH Aachen between 1994 and 2001 because of premature placental abruption. Excluded from the study were women with illnesses that changed the diagnosis of thrombophilia or who were pregnant. Under consideration of all factors for thrombophilia 45 women (80.36%) showed abnormalities in screening, 20 women (35.71%) had combined defects. Overall 26 women (46.43%) had either a factor V suffering, a prothrombin or MTHFR mutation or were carrier of the PAI 4G/4G polymorphism. Combined genetic defects only occurred with the 4G/4G variant in the PAI gene. Compared to information based on contemporary literature all mutations, except for the MTHFR mutation, occurred more frequently in the study than in the normal population. With regard to a control group of women who had not suffered pregnancy complications, however no significant results could be found. Only the MTHFR mutation occurred significantly less often in the study. The most frequent finding was a higher Factor VIII activity, the PAI 4G/4G polymorphism and a deficiency of Protein S. Despite the fact of having insignificant results and an insufficient number of comparable studies, it can be concluded that women with a premature placental abruption had an above average defect in their coagulation system.Beside studies of association between premature placental abruption and thrombophilia other studies are necessary that should attempt to validate the assumption that microthrombosia of women with a thrombophile constellation can lead to a placental abruption, or to explain how a hypercoagulability can lead to this pregnancy complication. Furthermore, studies are required that analyze and document the impact of a long-term use of lower molecular-heparin on the course of a pregnancy.
info:eu-repo/classification/ddc/610, Medizin, vorzeitige Thrombophilie, Plazentalösung, MTHFR-Mutation, Faktor V-Leiden-Mutation
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