Author/Editor     Meglič, Leon
Title     Genetski dejavniki tveganja pri venski trombozi v nosečnosti in puerperiju
Type     monografija
Place     Ljubljana Lljubljana
Publisher     Univerza v Ljubljani, Medicinska fakulteta
Publication year     2000
Volume     str. 67
Language     slo
Abstract     Background: Deep vein thrombosis (DVT) is a dangerous disease, because if undiagnosed it leads to pulmonary embolism (PE) in 50%, whereas 10% of patients with PE die. The prevalence of DVT in pregnancy ranges from 1 in 1000 to 1 in 2000 deliveries. The disease is the leading cause of maternal morbidity and mortality in the developed world. Besides physiologic hypercoagulability, the development of DVT in pregnancy and the puerperium may be also caused by thrombophilic defects. The aim of the study was to establish the prevalence of important inherited and acquired risk factors for development of DVT in pregnancy and the puerperium. Subjects and methods: Thirthy women (age 34 +- 6 years) with objectively confirmed DVT during pregnancy (N =19) or puerperium (N =11) were studied 6 (+- 4) years after event. Fifty-six women with normal pregnancies, who delivered in the same fortnight as the cases were included as controls. The groups did not differ in age or parity. Antithrombin (AT) and protein C (PC) activity were determined by chromogenic assays, free protein S (PS) by ELISA, lupus anticoagulants (LA) by dilute Russel's viper venom time and homocysteine by high pressure liquid chromatography and fluorimetric detection. Mutation R/Q506 and polymorphism 20210G/A were determined by polymerase chain reaction (PCR) and restriction enzymes, and -675(4G/SG) polymorphism by allele specific polymerase chain reaction. Results: Estimated prevalence of DVT in pregnancy and puerperium was 1 per 3000 deliveries. We found inherited defects which cause thrombophilia in 63.3% of affected women. The number of obstetrical problems in pregnancy and labour did not differ between the groups. (Abstract tuncated at 2000 characters).
Descriptors     PREGNANCY COMPLICATIONS
THROMBOPHLEBITIS
PREGNANCY
PUERPERIUM
ANTIPHOSPHOLIPID SYNDROME
RISK FACTORS
PREVALENCE
BLOOD COAGULATION DISORDERS
LUPUS ERYTHEMATOSUS, SYSTEMIC
ANTITHROMBINS
PROTEIN C
PROTEIN S
HOMOCYSTEINE
POLYMERASE CHAIN REACTION
SPECTROPHOTOMETRY
IMMUNOENZYME TECHNIQUES