Primary thrombophilia in México XII: Miscarriages are more frequent in persons with the Sticky Platelet Syndrome (SPS)

Guillermo J. Ruiz - Delgado,Andrés A. Leon - Peña,Juan Carlos Olivares - Gazca,Guillermo J. Ruiz - Argüelles,Ana K. Nuñez - Cortes,Mariana A. Mendez Huerta,Mónica Leon - Gonzalez,Yahveth Cantero - Fortiz

doi:10.4274/tjh.2016.0411

Abstract

Objective:Sticky platelet syndrome (SPS) is an inherited condition that leads to arterial and venous thrombosis. There is scant information about the association between SPS and obstetric complications. This study aimed to assess the relationship between SPS and fetal loss at a single institution.Materials and Methods:The obstetric histories of all consecutive female patients prospectively studied in a 324-month period at a single institution with a history of thrombosis and a clinical marker of primary thrombophilia were reviewed.Results:Between 1989 and 2016, 268 consecutive patients with a clinical marker of primary thrombophilia and a history of arterial or venous thrombosis were studied; of these, 108 were female patients. Within this subset of thrombophilic females, 77 (71%) had been pregnant at some point. Twenty-eight of these 77 patients (37%) had had a spontaneous abortion and 24 of those (86%) were found to have SPS. On the other hand, in a subset of 73 female patients with SPS who had been pregnant, 32% had miscarriages. These figures are significantly higher than the prevalence of spontaneous abortions in the general Mexican population of pregnant women, which is 12%-13% (chi-square: 7.47; p=0.0063). Accordingly, the relative risk of having a miscarriage is 2.66 times higher in female patients with SPS than in the general population (p=0.0014).Conclusion:In Mexico, female patients with SPS experience significantly more spontaneous abortions than the general population. Since the treatment of SPS is simple and effective and could in turn prevent adverse obstetric outcomes, its investigation in women treated for obstetric complications may be useful and deserves further research.

Highlights

Sticky platelet syndrome (SPS) was first described by Holliday et al [1] at the 9th Conference on Stroke and Cerebral Circulation in Arizona in 1983
In Mexico, we have found that SPS is the second most frequent cause of hereditary thrombophilia, only surpassed by the 677 mutation in the MTHFR gene [4,5,17]
A subset of 108 thrombophilic female patients was selected for further analysis; of these, 77 (71%) had been pregnant at some time, and within that subset, 28 (37%) had experienced at least one spontaneous abortion

Summary

Introduction

Sticky platelet syndrome (SPS) was first described by Holliday et al [1] at the 9th Conference on Stroke and Cerebral Circulation in Arizona in 1983. We and others have found that SPS is a common cause of arterial and venous thrombosis [2,3,4,5,6 ,7,8,9,10,11,12,13,14,15,16,17]. SPS is the second most common hereditary thrombophilic condition after resistance to activated protein C and the most common thrombophilia associated with arterial thrombosis, with an incidence of 21% [3,4,5]. In Mexico, we have found that SPS is the second most frequent cause of hereditary thrombophilia, only surpassed by the 677 mutation in the MTHFR gene [4,5,17]. SPS is the second most common thrombophilic condition that causes recurrent spontaneous abortions or fetal loss syndrome [18,19,20]. We have assessed the relationship between SPS in female patients and their obstetric histories, focusing on the history of miscarriages

Methods

Results

Discussion

Conclusion