Abstract
ObjectiveTo study the association between high activity of Factor II (prothrombin) in blood plasma with G20210A mutation and the development of great obstetrical syndromes.Material and methodsA prospective clinical cohort study was conducted on 290 pregnant women (average age 31.7 ± 4.7 years old). The main group was made up of 140 G20210A patients, while the control group comprised 150 women with the wild G20210G type. The aim was to evaluate the activity of Factor II in the venous blood plasma during the stages of pregnancy with regard to trophoblast invasion waves. As per results, association analysis of Factor II activity value and gestational complications was carried out.ResultsIn the control group, the median (Me) of Factor II activity ranged from 108% (preconception period) to 144% (pregnancy) [95% CI 130–150]. In patients with the GA type, the value was significantly higher in related periods, ranging from 149 to 181% [95% CI 142–195], p < 0.0001. With Factor II activity ranging from 148.5 to 180.6%, pregnancies in the main group had no complications. Higher levels of Factor II activity were associated with the development of early and/or severe preeclampsia (PE) and fetal growth retardation (FGR).ConclusionThe data obtained regarding Factor II activity in blood plasma, juxtaposed with the development of great obstetrical syndromes, allow to assume that manifestation of G20210A in early and/or severe PE and FGR is associated with this coagulation factor’s level of activity. Threshold value of the Factor II activity with G20210A mutation, allowing to predict the development of PE, comprised 171.0% at the preconception stage (AUC – 0.86; p < 0.0001) and within 7–8 weeks of gestation it was 181.3% (AUC – 0.84; p < 0.0001).
Highlights
Prothrombin G20210A mutation was first described by Poort S.R. and his colleagues in 1996 [1]
In patients with the Prothrombin G20210A mutation (GA) type, the value was significantly higher in related periods, ranging from 149 to 181% [95% confidence interval (95% CI) 142–195], p < 0.0001
Higher levels of Factor II activity were associated with the development of early and/or severe preeclampsia (PE) and fetal growth retardation (FGR)
Summary
Prothrombin G20210A mutation was first described by Poort S.R. and his colleagues in 1996 [1] It represents the nucleotide replacement of guanine (G) with adenine (A) in the 3-untranslated region of the gene (20210), which leads to an increase in the prothrombin level in Currently, there is good evidence regarding the association of GA genotype with the risk of thromboses [8,9,10] occurring due to an increase in both the level and activity of prothrombin in blood plasma [1, 11, 12]. Nikolaeva et al Thrombosis Journal (2021) 19:41 It is still questionable whether there is association of prothrombin G20210A mutation with the risk of developing pregnancy complications. It is obvious that the previously described vascular microthromboses of the placental bed in women with genetic thrombophilia [18,19,20,21] are to be associated with a hypercoagulable shift due to the excessive activity of Factor II [22]
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