The evaluation of perinatal outcomes in pregnancies complicated with thrombophilias

Aim: In our study we included pregnant patients diagnosed (according to predetermined criteria) with thrombophilia and evaluated their follow up by thromboprophylaxy for perinatal outcomes. In addition to our study group we aimed to evaluate a control group with negative thrombophilia screen results and hypothesized similar perinatal outcomes in comparison with the study group.Materials-Methods: Pregnant subjects that applied to Çukurova University Hospital - Department of Obstetrics and Gynaecology, between June 2010 - February 2012 were recruited in the study. Patients with past history of recurrent miscarriages who had previously been investigated for miscarriage aetiology with only thrombophilia identified as sole factor for miscarriage were included into the study. Patients with a positive thrombophilia screen were initiated a thromboprophylaxia protocol in the first trimester and their demographic backgrounds and past obstetric histories were also recorded. In addition to this, the type of thrombophilia and number of thrombophilia defects were also noted and the route of birth and perinatal outcomes were evaluated prospectively. The control group included patients who had a history of recurrent unexplained miscarriages, with a negative thrombophilia screen. Differences between both groups were statistically significant at a p value <0.05.Results: 60 patients with recurrrent miscarriages and positive thrombophilia screen were included in the study group, while 50 patients with unexplained recurrent miscarriage composed the control group. When the perinatal outcomes of both the study and the control groups were compared; first trimester miscarriage rates (%11.7 (7/60), %8 (4/50), p=0.487), second trimester pregnancy loss (%0 (0/80), %2 (1/50), p=0.487), third trimester pregnancy loss (%1.7 (1/60), %0 (0/50), p=0.487), development of preeclampsia/eclampsia (%3.3 (2/60), %8 (4/50), p=0.257), Small for gestational age birth rate (%3.3 (2/60), %4 (2/50), p=0.619), preterm birth rate (%16.7 (10/60), %10 (5/50), p=0.232) and the incidence of venous thrombosis (%11.7 (7/60), %6 (3/50), p=0.246) did not differ significantly. The cesarean section rate in the study group was 55% (33/60) and 18% (9/50) in the study group (p=0.000) and it was statistically significant between both groups.Discussion: Our study discovered similar findings and perinatal outcomes in patients with and without thrombophilia. The only significant difference between both groups was the difference in cesarean rates. The fact that the thrombophilia group in fact had thromboprophylaxy therapy may explain the similar results between the two groups. Potential therapy modalities and the effects of thrombophilias upon pregnancies can only be further investigated by planning more highly populated prospective randomized studies.