Factor v leiden mutation (fvlm) compared to placental histopathology in recurrent unexplained second and third trimester fetal loss

Document Type : Original Article

Author

Fellow of Obstetrics and Gynecology, Al -Zahraa University Hospital 2010

Abstract

Objective: This study was performed to detect FVL mutation in women with unexplained
second and third trimester fetal loss and to compare the presence of FVL mutation with
placental histopathology in these women.
Patients & Methods: The present study included two groups: group (I) represented sixty
pregnant patients with history of recurrent unexplained fetal loss. The group is subdivided
into group (Ia): 30 patients in their 2nd trimester and group (Ib): 30 patients in their 3third
trimester. Group (II): 20 healthy multiparous patients with no previous history of fetal loss
as a control group. Ultrasound scanning of the placenta and blood sampling for detection
of FVLm for all women were done during pregnancy. Histopathologic examination of the
placenta was performed after the pregnancy has ended.
Results: There was no significant difference in the presence of FVL mutation between patients with recurrent unexplained fetal losses (5/60 = 8.3%) and the control group. Normal
factor V genotype was detected in 55/60 of the patient with fetal loss (28/30) of the 2nd trimester abortion and 27/30 of the 3rd trimester fetal death; these results were not statistically
significant. Ultrasonography of the placenta reflected pathological findings (calcification
and degeneration) in second trimester abortion and third trimester intrauterine fetal death
which was highly statistically significant than the control group (P<0.01). Histopathological
examination of the placenta (infarction and thrombosis) was statistically of higher significance in cases with history of fetal loss than the control group (P< 0.01).
Conclusion: Screening for FVL mutation is not recommended as routine screening test in
cases with recurrent fetal loss although still highly indicated in cases with past history of
thrombosis.

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