Abstract Number: PB2565
Meeting: ISTH 2020 Congress
Background: Physiological hypercoagulable state is a normal condition in pregnancy, but if it happened in parallel with other conditions such as thrombophilia, it will be aggravated and lead to pregnancy complications. Protein S deficiency is an inherited thrombophilia associated with recurrent pregnancy loss. The use of anticoagulants, such as fondaparinux, as treatment of recurrent pregnancy loss, is still debatable.
Aims: To investigate the effect of fondaparinux in pregnant women with recurrent pregnancy loss and protein S deficiency.
Methods: Cases of four patients with recurrent pregnancy loss and protein S deficiency were reported. All patients have experienced at least two recurrent miscarriages. There was no anatomical abnormality, medical condition such as autoimmune and metabolic disorders, and other thrombophilia. The level of protein S, d-Dimer, fibrinogen, and INR were monitored during pregnancy. Fondaparinux in a dose of 2.5 mg daily (at the same time each day) was given to all patients from the day when their pregnancies were confirmed to 24 hours before delivery. Live birth and complication as pregnancy outcomes were assessed.
Results: The mean age of our patients was 31.75 y. o. The level of protein S in all patients decreased in the third trimester. The mean of protein S in the first trimester was 38.75% and the third trimester was 29%. Meanwhile, the level of d-Dimer and fibrinogen in our patients were increased. Despite these results, we continued using fondaparinux at the same dose. All patients delivered singletons live births by cesarean section at 37-38 weeks of gestation. There was no abnormal bleeding or other complications in the mother and child.
Conclusions: Treatment with fondaparinux 2.5 mg daily might have a benefit to women with recurrent pregnancy loss and protein S deficiency.
To cite this abstract in AMA style:Permatasari A, Savitri M, Ramadhan PZ, Bintoro UY, Ashariati A. Successful Pregnancy Outcomes in Patients with Protein S Deficiency Treated with Daily Fondaparinux Regimen [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/successful-pregnancy-outcomes-in-patients-with-protein-s-deficiency-treated-with-daily-fondaparinux-regimen/. Accessed October 19, 2021.
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