Frequency of hereditary thrombophilia in women with recurrent pregnancy loss in N orthern P akistan

AIM: Hereditary thrombophilia (HT) screening is performed as routine work-up of recurrent pregnancy loss (RPL) in Pakistan. In Northern Pakistan the prevalence of HT is not known. HT is not detected in the majority of RPL cases, especially in patients with ≤ 3 pregnancy losses (PL). The aim of this study was to determine the frequency of HT in women with RPL, and to find the prevalence of HT in patients with ≤ 3 PL and > 3 PL. MATERIAL AND METHODS: Lupus-anticoagulant-negative patients with unexplained RPL were screened for protein C, protein S, antithrombin, and factor V Leiden. RESULTS: A total of 315 patients with RPL were screened and 13 (4%) had evidence of HT. Protein C and protein S deficiency were detected in 6/140 (4.3%) women with > 3 PL and in 2/175 (1.1%) women with ≤ 3 PL. Antithrombin deficiency was detected in 2/140 (0.75%) women with > 3 PL and in no patients with ≤ 3 PL. Factor V Leiden was detected in 3/26 (12%) women with > 3 PL and in no patients with ≤ 3 PL. The prevalence of HT in patients with >3 PL was significantly higher than in patients with ≤ 3 PL (P = 0.002). We detected a strong association between HT and >3 PL (odds ratio 7.3; 95% confidence interval: 1.60-33.85) as compared to ≤ 3 PL. CONCLUSION: HT was detected in 4% of patients with RPL. The prevalence of HT in patients with > 3 PL is significantly higher than in patients with ≤ 3 PL.