Coagulation Status in Women With Missed Abortion

Abstract

\n Background: Missed abortion is a special type of spontaneous miscarriage, as well as a complex and multifactorial reproductive health problem that affects people all over the world. The purpose of this study was to assess the status of coagulation function in a large series of reproductive-age women diagnosed as missed abortion. Likewise, we want to explore the association between coagulation and missed abortions, in order to evaluate whether they could be used as early predictive factors for missed abortions.Methods: A total of 11182 women who suffered from missed abortion from Peking University Third Hospital and 5298 healthy age –matched early pregnancy women were enrolled in our study. Coagulation function test (prothrombin time, activated partial thromboplastin time), fibrinolysis status detection (fibrinogen, D-Dimer), anticoagulation function tests (protein C, protein S and antithrombin III) and lupus anticoagulants (LAC) were examined on an automated coagulation analyzer. In addition, platelet counts were detected by automated hematology analyzer. Platelet aggregation (PAgT) were tested by light transmission aggregometry (LTA). All tests were taken according to standard operating procedures of the instruments.Results: Compared with healthy pregnancy, the level of D-Dimer and platelet count were higher, and the antithrombin III (AT-III) activity was lower(P<0.05). 13.1% patients with missed abortion were positive for LAC, and platelet aggregation was increased in 47.4% patients. There were no significant differences in the levels of PT, aPTT, TT, fibrinogen, protein C and protein S between the patients with missed abortion and healthy pregnancy. Moreover, multivariate logistic regression analysis showed that D-Dimer, dRVVT-R, AT-III and PAgT had significant predictive value for missed abortion.Conclusion: These findings provide evidence of hypercoagulability in patients with missed abortion. Lupus anticoagulant, PAgT and D-Dimer were the strongest predictors of missed abortion. These data suggest that treatment of the lupus anticoagulant and antiplatelet aggregation could be considered in missed abortion.