Eveluation of delivery outcomes and complications of term pregnants with hereditary thrombophilia

Objective: The aim of the present study was to evaluate perinatal outcomes of pregnant women diagnosed with thrombophilia through the criteria determined who had delivery at term (loss of pregnancy, preeclampsia, intrauterine growth retardation, abruptio placenta, venous thrombosis etc.) including the mode of delivery, APGAR scores, prophylaxis of thrombosis, and perinatal outcomes of the pregnant women without any history of thrombophilia who had delivery during the same period (loss of pregnancy, preeclampsia, intrauterine growth retardation, abruptio placenta, venous thrombosis etc.), and to compare the mode of delivery and the APGAR scores. Material and method: The present research included the patients who had delivery at term in Obstetrics and Gynecology Clinic of Afyonkarahisar Health Sciences University, Medical Faculty Hospital between July, 1, 2017 and October, 31, 2021. The miscarriage caused by recurrent loss of pregnancy was investigated in the case group and the patients with positive hereditary thrombophilia were included into the study. Demographic characteristics, previous pregnancy history of the patients, thrombophilia types, and number of thrombophilia defects of the patients were recorded. The control group of this retrospective study on mode and outcomes of the delivery was created from the patients without history of thrombophilia who had delivery in our clinic at term. The p value below 0.05 was taken for statistical importance level for study results. Results: Etiological screening was performed due to recurrent pregnancy loss within the scope of the study; 50 pregnant women with hereditary thrombophilia who have delivered at term were included in the study group, and 50 pregnant women without a history of thrombophilia were included in the control group. Forty-six (92%) patients with thrombophilia had history of abortion whereas 13 (25%) of the pregnant women who had delivery at term had history of abortion (p<0.001). The mean number of pregnancies in the women with hereditary thrombophilia was 3.90±1.329 (minimum 1, maximum 8); and the mean number of pregnancies in the women in the control group was 2.36±1.425 (minimum 1, maximum 6). A statistically significant difference was detected between two groups for number of mean number of pregnancies (p<0.001). Both groups were compared for preaclempsia, thromboembolism, and development of IUGR complications; 3 (6%) patients with preeclampsia were detected in the case group; however, there was not any patient with preeclampsia in the control group (p=0.887). Thromboembolism was detected in 1 (2%) patient in the case group and none of the patients in the control group (p=0.399). IUGR was detected in 4 (8%) patients in the case group and none of the patients in the control group (p=0.247). There was not any statistically significant difference for complication development. No significant difference was detected for complications in the comparison of the patients receiving DMAH (5 complications) or DMAH+ASA (3 complications) in the case group (p=0.68). Conclusion: The comparison of the groups for obstetric results reveals a statistically significant difference in results except number of abortion and births in the case and the control group. When compared with other studies, some complications of which an association was shown with hereditary thrombophilia cases was not associated with hereditary thrombophilia in this study. This may be caused by limited number of the study group. Further prospective and randomized studies with larger patient series should be planned in order to clarify the effect of hereditary thrombophilia on the pregnancy. Keywords: Hereditary thrombophilia, obstetric complication, term delivery.