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Keywords:
Obstetrics (Pregnancy / birth / postnatal period), Management, Ultrasound, Ultrasound-Colour Doppler, Ultrasound-Spectral Doppler, Screening, Treatment effects, Foetus, Obstetrics, Haematologic diseases
Authors:
M. R. M. Machado, M. C. Chammas; São Paulo/BR
DOI:
10.1594/ecr2015/C-2233
Methods and materials
During the period from June 2012 to August 2013,
a prospective observational case-control study was carried out in the Section of Gynecology and Obstetrics of a private medical clinic in cooperation with the University State of São Paulo (USP),
Brazil.
Institutional review board approval was obtained for this study.
Data were collected at entry to the study,
by personal interview.
Sonographic images of the obstetrical exams of patients in this study were obtained from B-mode and color Doppler amplitude.
Two groups of women were enrolled.
We studied 60 pregnant women,
between 20 and 38 weeks of gestation with history of recurrent pregnancy loss (RPL) may be in the 1st,
2nd or 3rd trimester and / or thrombotic placental damage.
We analyzed these patients by using gray-scale ultrasound (US) and blood flow resistance in the uterine and umbilical arteries,
assessed by multigate Doppler examinations.
After we compared them to 70 healthy reproductive women,
without pregnancy complications (intrauterine growth restriction,
stillbirth,
and abruption placentae).
Cases and controls were tested for the mutations: factor V Leiden mutation (G1691A) (FVL),
prothrombin mutation (G20210) (FII),
methylenetetrahydrofolate reductase mutation (C677T) (MTHFR),
and protein C,
protein S and Antithrombin III deficiencies.
Odds ratio (OR) at confidence interval (CI) of 95% was used as a measure of association between the mutations and RLP and thrombotic placental damage (gray-scale US and resistance blood flow Doppler in uterine and umbilical arteries).
However,
the major limitation common to most studies was the failure to identify additional risk factors in the populations studied.