Determination of Antiphospholipid antibodies and Thrombophilia in women with Recurrent Miscarriage

Abstract

Recurrent miscarriage is a_critical problem in which many factors play a crucial role such as antiphospholipid antibodies (APA) and anticardiolipin antibodies (ACA). This study was a case control study, was conducted from Febraury-2008 to February - 2011 in Khartoum State; it determined the haemostatic abnormalities and the frequency of the primary and secondary antiphospholipid syndrome in women with history of recurrent miscarriage (RM). A total of 100 women with three or more consecutive recurrent miscarriage as case group and 100 non complicated pregnant women as control group were enrolled in this study and were interviewed through clinically structured questionnaire to assess the risk factors for RM and an informed consent were obtained from them. Patient and control groups were screened for the presence of antinuclear antibodies (ANA), anti-double stranded DNA (anti- dsDNA), antiphospholipid antibodies (APA IgM/IgG), and anticardiolipin antibodies (ACA/IgG) by using Enzyme linked Immuno-Sorbent assay (ELISA). The platelets were counted using Sysmex KXN-21. Activated Partial thromboplastin time (APTT), Prothrombin time (PT) and Thrombin Time (TT) were measured using coagulometer biobas 10. Women positive for APA were repeated the measuring of APA level after 6 as confirmatory test. All tests were analyzed using Statistical Packages of Social Sciences Version 17 (SPSS program). Results showed that the frequencies for both APA and ACA were 20%, ANA and Anti- dsDNA were 12%, thrombocytopenia was 8%, LA was 20% , 5% had prolonged PT, where as the remaining patient and control groups had normal results. There were a significant correlation between Age and the presence of APA (P=0.03), ACA (IgG) (P=0.04), ANA and Anti-dsDNA (P=0.0l3), LA (P=0.033) and thrombocytopenia (P=0.02), whereas PT had not influenced by age. The data concluded_ that the frequencies of APA, ACA, ANA, Anti-dsDNA, LA and thrombocytopenia in women with RM obtained in this study were in agreement to the frequencies for these parameters obtained in previous studies and their presence were significantly associated with recurrent miscarriage. The current study recommends measuring of APA, ACA, Anti-dsDNA-antibodies, APTT and PT in all women with 3 or more consecutive pregnancy loss.