Evaluation of the role of thrombophilia associated factors in pre-eclampsia

To evaluate the role of thrombophilia associated factors in pre-eclamptic pregnant women. A case control study was conducted on 30 severe pre-eclamptic pregnant women [group A], and 30 normotensive pregnant women [group B] from Shatby University Maternity Hospital. Routine laboratory tests, protein C, protein S, antithrombin III, factor V Leiden and anticardiolipin antibodies [IgM, IgG] were measured for both groups. Informed consent of the patients was taken. There was not any significant difference in the values of factor V Leiden, protein C, protein S, antithrombin III, and anticardiolipin IgG between pre-eclamptic and normotensive pregnant women. However, anticardiolipin IgM was shown to be significantly higher in the pre-eclamptic patients. Severe pre-eclamptic patients were 3.5 times more likely to develop elevated levels of anticardiolipin IgM. Routine screening for inherited thrombophilia disorders is not recommended in pre-eclamptic females

Factor XII deficiency and habitual abortion: the Haegman connection

To evaluate the role of factor XII deficiency in cases of habitual abortions. A case control study was conducted on 50 women with history of three or more consecutive first-trimester abortions [group A] of unexplained nature from outpatient clinic of Shatby Maternity University Hospital, and 25 healthy women with no history of recurrent miscarriage, thrombotic disease or adverse pregnancy outcomes [group B]. Blood sample was taken from each patient to assay the following parameters: protein S [PS], protein C [PC], antithrombin III [ATIII], and coagulation factor XII [FXII]. The subsequent miscarriage rate with abnormal FXII is significantly higher than that with normal FXII. However, there were no statistically significant differences in the subsequent miscarriage rates between normal and abnormal PC, PS and ATIII values. Factor XII deficiency might play a role in recurrent miscarriages

Plasma markers of thrombin generation, fibrinolysis and activated platelets in sickle cell disease

Thrombotic phenomenon has an important role in the vasooclusive manifestations of sickle cell disease [SCD] that dominate its clinical spectrum. For evaluation of thrombotic activities in SCD patients, the markers of thrombin generation: thrombin anti-thrombin complex [TAT] and prothrombin fragment 1, 2 [F 1, 2], enhanced fibrinolysis markers: plasmin anti- plasmin complex [PAP] and D-dimer and platelet activation markers: platelet factor 4 [PF4] and B - thromboglobulin [BTG] were measured in 35 patients with SCD [25 during steady state and 10 during crisis], compared to 12 normal controls. The measurements were performed by enzyme-linked immunosorbent assays. The thrombotic markers [TAT and F 1, 2], fibrinolytic markers [PAP and D-dimer] and platelet activation markers [PF4 and BTG] were significantly increased in SCD patients during steady state. During vasooclusive crisis, there were marked increase in TAT, D- dimer, BTG and PF4 while there was no significant increase in the levels of PAP and F 1, 2. Also, there was significantly positive correlation among thrombin generation markers, platelet activation markers and fibrinolysis markers in SCD patients during steady state. During episodes there was significant positive correlation among markers of thrombin generation, fibrinolysis and platelet activation except PAP and F 1, 2 markers as compared with asymptomatic intervals. We concluded that, during pain episodes, there was enhanced platelet procoagulant activity, elevated fibrinolytic activity and thrombin generation. These changes may predict the frequency of pain. These findings suggested that increased their levels may increase the risk of thrombosis in these patients and establish a relationship between the laboratory determination of these parameters and clinical pain episodes in patients with SCD. The findings of platelet activation, fibrinolytic activity and thrombin generation in asymptomatic patients indicate ongoing subclinical thrombogeinc activity in patients with SCD

Study of some coagulation and fibrinolytic parameters in schistosomal cases

Schistosomiasis is a major health problem in various parts of the world and Egypt. The disease is well known for the bleeding tendency that may result from diminished synthesis of coagulation factors, fibrinolytic system activation and consumption coagulopathy. This work attempted to evaluate the role of the ascitic fluid milieu in the hypercoagulability that may be observed in schistosomal hepatic fibrosis. Three parameters were assayed; prothrombin fragment 1+2[PF 1 + 2], thrombin-antithrombin complex [TAT] and fibrin monomers [FM]. These parameters were assayed both in the plasma and ascitic fluid simultaneously. The study was carried out on 18 schistosomal patients with hepatic fibrosis and tense ascites. The values of PF 1+2, TAT were significantly correlated both in plasma and ascitic fluid, while FM although was higher than the expected values yet was not significantly associated to either of the two other parameters. We concluded from this study that the ascitic fluid can be an important source of pro-coagulant material to the plasma in ascitic patients with schistosomal hepatic fibrosis