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C0345 Obstetric outcomes and thrombotic risk in women approaching art procedures: A prospective cohort study.
S202
Abstracts / Thrombosis Research 130 (2012) S100–S202
Comment: The results suggest that IVIG therapy significantly influences the course of pregnancy in women with miscarriage and APS, reducing the incidence of complications and improve perinatal outcome. doi:10.1016/j.thromres.2012.08.319
C0315 Comparison of different D-dimer assays in normal pregnancy Natalya Silinaa, Olga Golovinaa, Olga Smirnovaa, Alla Nikolaevab, Ludmila Papayana a Russian Research Institute of Haematology and Transfusiology - 2nd Sovietskaya 16; bAntenatal clinic #22 - Sikeyrosa 10A Background: Normal pregnancy is associated with hypercoagulation state and activation of fibrinolysis. D-dimer is an important test of activation of haemostasis. D-dimer concentration progressively increases during normal pregnancy. It is important to establish normal deviations of D-dimer for physiological pregnancy with different assays. Methods: The citrate plasmas of 117 healthy pregnant women at the age of 19 till 40 years were evaluated. D-dimer levels were measured by ELISA (“Asserachrom D-DI”, Diagnostica Stago, France), quantitative immunoturbidimetric latex agglutination assay (“Auto Blue D-dimer 400”, England) and semi quantitative latex agglutination assay (“DDimer Test”, Diagnostica Stago, Roche, France). STATISTICA 6.0 was used. Results are given as median (Me) with 95% confidence intervals (CI) for each gestational period. A P b 0.05 was considered statistically significant. Results: Results of the ELISA-method were increased both between I and II trimesters (172.45-1109.75 ng/ml FEU vs 244.40-1268.00 ng/ml FEU respectively; p b 0.01) and II and III trimesters (244.40-1268.00 ng/ ml FEU vs 512.25-1891.50 ng/ml FEU respectively; p b 0.01). Parameters of the quantitative immunoturbidimetric latex agglutination assay were significantly high between I and II trimesters (6.90-468.55 ng/ml vs 57.00-1434.50 ng/ml) only. The results of the latex test were reported in three categories: normal (b500 ng/ml FEU), positive (500-3000 ng/ml FEU) and over positive (N3000 ng/ml FEU). High D-dimer level was in 68.2% of pregnant women even in I trimester. In II and III trimesters positive and over positive results were increased to 82.4% and 90.9% respectively whereas normal results were 17.6% and 9.1% respectively. Comment: It is recommended that D-dimer be estimated by the most informative ELISA. This quantitative assay adequately evaluates D-dimer level in each trimester of pregnancy. doi:10.1016/j.thromres.2012.08.320
C0345 Obstetric outcomes and thrombotic risk in women approaching art procedures: A prospective cohort study. Michela Villania, Giovannia, Luca Tisciaa, Francesco Dentalib, Donatella Colaizzoa, Filomena Cappuccia, Lucia Fischettia, Walter Agenob, Maurizio Margaglionec, Elvira Grandonea a IRCCS CSS, Thrombosis and Haemostasis Unit - Viale Padre Pio, 71015 San Giovanni Rotondo (Foggia) -Italy; bDepartment of Clinical Medicine, University of Insubria - Varese; cMedical Genetics, University of Foggia Viale Pinto, 71100 Foggia, Italy Background: Assisted reproductive technologies (ART) have been widely used on couples suffering from infertility. The clinical pregnancy rate is low, varying from 20 to 35% per cycle started. The role of antithrombotic drugs in improving pregnancy rate is controversial, although some fertility clinics have adopted different protocols either in thrombophilic and non-thrombophilic women. Methods: Between March 1998 and July 2011 we prospectively evaluated a cohort of 1107 women approaching ART (2214 cycles) consecutively referred to our thrombosis unit (S. Giovanni R.). All were investigated for inherited and acquired thrombophilias. Median follow-up was 34.53 months (range 2 - 143 months). Results: At the enrolment, 327 women (29.5 %) have experienced 946 ART cycles. One hundred twenty-two (37.3 %) women obtained a clinical pregnancy (176 pregnancies), with 21(16 %) live- born children. Overall, 115 (10.4%) women carried at least one thrombophilia (45 FVL, 57 PTm, 13 severe thrombophilias). After screening, 595 (53.8 %) underwent at least 1 attempt (1268 cycles, 27 lost to follow-up). In 424 (33.4%) cycles an antithrombotic prophylaxis (342 treated with aspirin, 66 with LMWH, 16 with aspirin + LMWH) was used. The pregnancy rate was 21.4% (265/1241 cycles) with 171 (13.8%) live-born children. As far as the antithrombotic prophylaxis is concerned, a clinical pregnancy was obtained in 96 out of 424 (22.6%) treated cycles (p: 0.42, OR: 1.1, 95% CI: 0.8-1.5 vs pregnancy rate in untreated cycles). The rate of live-born was not significantly different in treated vs untreated cycles (p: 0.73, OR: 0.9, 95% CI: 0.6-1.3) prophylaxis. Overall, 7 thrombotic events (3 PE, 3 DVT, 1 arterial thrombosis; 6 of them in untreated women) were observed. Among them, 4 (0.3%, 2 DVT, 2 PE ) occurred after screening, and only 1 during LMWH prophylaxis. Comment: In women undergoing ART procedures, the use of antithrombotic prophylaxis is not associated with an improved pregnancy rate or live-born children. Thrombotic complications are less frequent in women receiving an antithrombotic prophylaxis. doi:10.1016/j.thromres.2012.08.326
Abstracts / Thrombosis Research 130 (2012) S100–S202
Comment: The results suggest that IVIG therapy significantly influences the course of pregnancy in women with miscarriage and APS, reducing the incidence of complications and improve perinatal outcome. doi:10.1016/j.thromres.2012.08.319
C0315 Comparison of different D-dimer assays in normal pregnancy Natalya Silinaa, Olga Golovinaa, Olga Smirnovaa, Alla Nikolaevab, Ludmila Papayana a Russian Research Institute of Haematology and Transfusiology - 2nd Sovietskaya 16; bAntenatal clinic #22 - Sikeyrosa 10A Background: Normal pregnancy is associated with hypercoagulation state and activation of fibrinolysis. D-dimer is an important test of activation of haemostasis. D-dimer concentration progressively increases during normal pregnancy. It is important to establish normal deviations of D-dimer for physiological pregnancy with different assays. Methods: The citrate plasmas of 117 healthy pregnant women at the age of 19 till 40 years were evaluated. D-dimer levels were measured by ELISA (“Asserachrom D-DI”, Diagnostica Stago, France), quantitative immunoturbidimetric latex agglutination assay (“Auto Blue D-dimer 400”, England) and semi quantitative latex agglutination assay (“DDimer Test”, Diagnostica Stago, Roche, France). STATISTICA 6.0 was used. Results are given as median (Me) with 95% confidence intervals (CI) for each gestational period. A P b 0.05 was considered statistically significant. Results: Results of the ELISA-method were increased both between I and II trimesters (172.45-1109.75 ng/ml FEU vs 244.40-1268.00 ng/ml FEU respectively; p b 0.01) and II and III trimesters (244.40-1268.00 ng/ ml FEU vs 512.25-1891.50 ng/ml FEU respectively; p b 0.01). Parameters of the quantitative immunoturbidimetric latex agglutination assay were significantly high between I and II trimesters (6.90-468.55 ng/ml vs 57.00-1434.50 ng/ml) only. The results of the latex test were reported in three categories: normal (b500 ng/ml FEU), positive (500-3000 ng/ml FEU) and over positive (N3000 ng/ml FEU). High D-dimer level was in 68.2% of pregnant women even in I trimester. In II and III trimesters positive and over positive results were increased to 82.4% and 90.9% respectively whereas normal results were 17.6% and 9.1% respectively. Comment: It is recommended that D-dimer be estimated by the most informative ELISA. This quantitative assay adequately evaluates D-dimer level in each trimester of pregnancy. doi:10.1016/j.thromres.2012.08.320
C0345 Obstetric outcomes and thrombotic risk in women approaching art procedures: A prospective cohort study. Michela Villania, Giovannia, Luca Tisciaa, Francesco Dentalib, Donatella Colaizzoa, Filomena Cappuccia, Lucia Fischettia, Walter Agenob, Maurizio Margaglionec, Elvira Grandonea a IRCCS CSS, Thrombosis and Haemostasis Unit - Viale Padre Pio, 71015 San Giovanni Rotondo (Foggia) -Italy; bDepartment of Clinical Medicine, University of Insubria - Varese; cMedical Genetics, University of Foggia Viale Pinto, 71100 Foggia, Italy Background: Assisted reproductive technologies (ART) have been widely used on couples suffering from infertility. The clinical pregnancy rate is low, varying from 20 to 35% per cycle started. The role of antithrombotic drugs in improving pregnancy rate is controversial, although some fertility clinics have adopted different protocols either in thrombophilic and non-thrombophilic women. Methods: Between March 1998 and July 2011 we prospectively evaluated a cohort of 1107 women approaching ART (2214 cycles) consecutively referred to our thrombosis unit (S. Giovanni R.). All were investigated for inherited and acquired thrombophilias. Median follow-up was 34.53 months (range 2 - 143 months). Results: At the enrolment, 327 women (29.5 %) have experienced 946 ART cycles. One hundred twenty-two (37.3 %) women obtained a clinical pregnancy (176 pregnancies), with 21(16 %) live- born children. Overall, 115 (10.4%) women carried at least one thrombophilia (45 FVL, 57 PTm, 13 severe thrombophilias). After screening, 595 (53.8 %) underwent at least 1 attempt (1268 cycles, 27 lost to follow-up). In 424 (33.4%) cycles an antithrombotic prophylaxis (342 treated with aspirin, 66 with LMWH, 16 with aspirin + LMWH) was used. The pregnancy rate was 21.4% (265/1241 cycles) with 171 (13.8%) live-born children. As far as the antithrombotic prophylaxis is concerned, a clinical pregnancy was obtained in 96 out of 424 (22.6%) treated cycles (p: 0.42, OR: 1.1, 95% CI: 0.8-1.5 vs pregnancy rate in untreated cycles). The rate of live-born was not significantly different in treated vs untreated cycles (p: 0.73, OR: 0.9, 95% CI: 0.6-1.3) prophylaxis. Overall, 7 thrombotic events (3 PE, 3 DVT, 1 arterial thrombosis; 6 of them in untreated women) were observed. Among them, 4 (0.3%, 2 DVT, 2 PE ) occurred after screening, and only 1 during LMWH prophylaxis. Comment: In women undergoing ART procedures, the use of antithrombotic prophylaxis is not associated with an improved pregnancy rate or live-born children. Thrombotic complications are less frequent in women receiving an antithrombotic prophylaxis. doi:10.1016/j.thromres.2012.08.326