Background: Pregnancy is an acquired hypercoagulable state. Moreover, many studies show that the acquired or inherited thrombophilia can be associated with recurrent pregnancy loss.

Aims: We have aimed to evaluate the coagulation status of patients with pregnancy complications in a large scale design

Methods: In this retrospective observational study, we evaluate 1345 patients with pregnancy complications that referred to the Iranian Blood Transfusion Organization. We use prothrombin time (PT) and activated partial prothrombin time (aPTT) to screen these patients and evaluate the clinical history, the prevalence of activated protein C resistance (APCR), protein C(PrC), protein S(PrS), and antithrombin III deficiencies, Lupus Anticoagulant (LA) and factor deficiency

Results: The most frequent complaint was thrombophilia (97.3%), followed by Bleeding and thrombosis (1.9%) and bleeding tendency (0.5%). We observed 39.4%, 11.9% and 1.3% abortion in first, Second and third-trimester, respectively. Out of the 1219 thrombophilic patients, 94.1% had a negative thrombophilia screen, while 5.7% had at least one thrombophilic defects. The most frequent defect was APCR (3%), followed by pregnancy-induced PrS deficiency (1.6%), LA (0.3%), AT (0.2%), PrC (0.2%), PrS (0.2%). In a close observation of 19 patients with Bleeding and thrombosis and 6 with a bleeding tendency, 79.2% and 85.7% of both groups were normal in coagulation screening.

Conclusion(s): Our findings indicate that thrombophilia can be a common presentation in women with pregnancy loss, but the majority of these patients have a negative thrombophilia screen. Recurrent miscarriage and thrombophilia are merely associated, and the evidence for possible benefits of thrombophilia screening is lacking.

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/what-is-the-extent-of-coagulation-abnormalities-in-the-development-of-pregnancy-complications/