Prevalence of thrombophilia in patients with a stillbirth
Villar Ruiz OP, Batllori Badia E, Bebia Conesa V, García Alcázar D, Barbero Casado P, Forcén Acebal L.
Obstetrics and Cynecology Service, Hospital Universitario “12 de Octubre”.
The casual relation between thrombophilia and stillbirth remains controversial. To assess the prevalence of thrombophilia in patients with a stillbirth attended at our centre between 2007-2017
Descriptive study. Main variable: Prevalence of thrombophilia in patients with fetal loss >16 GW
Secondary variables: demographic data (BMI, age), smoking status, obstetric history (OH), anatomopathological (AP) findings of fetus and placenta, other pregnancy outcomes related to thrombophilia.
Prevalence of thrombophilia: 13,16% (n=32). Most frequent thrombophilia: Protein S deficiency (4,93%, n=12). Mean BMI: 26 (19-41, CI 95%); Mean age: 35 y.o.(29-41, CI 95%). Smoking status: 21,9% (n=7) were smokers. OH: previous stillbirth (3,12%, n=1), recurrent miscarriages (3,12%, n=1). AP findings: placental infarction (31,25%, n=10), umbilical cord thrombosis (6,25%, n=2). Other pregnancy outcomes: RCIU (9,4%, n=3), abruptio placentae (6,25%, n=2).
The most common thrombophilia in our patients is protein S deficiency, which also has a higher than expected prevalence. We found no differences in the prevalence of the rest of thrombophilias when compared to general population. In those cases where thrombophilia was identified, it was difficult to establish whether it was a determining factor for stillbirth. Some AP findings like placental infarction or umbilical cord thrombosis, in the absence of other potential underlying causes, may support that thrombophilia played a major role. Our data does not support the need to investigate, in a systematic manner, the presence of thrombophilia in patients with unexplained stillbirth. However, we do consider studying those patients with AP findings which could suggest the presence of a thrombophilia. There is still the need for larger, well designed studies, in order to clarify if there are any subgroups of patients which may benefit from diagnosis and treatment of a potential underlying thrombophilia.
Patient data has been collected from database used during patient consultations of our perinatal mortality outpatient clinic. This data is stored and only the main authors have the right to access to personal data to ensure subject safety. No personal data has been used to write this retrospective descriptive study, therefore no ethical approval (further than Heads of Service) has been required. The authors declare no conflict of interest.
Thrombophilia, stillbirth, prevalence, causal relation