Öz
Abstract
Aim. The aim of this study was evaluate the relationship between preeclampsia and antiphospholipid antibodies. Methods. A total of 116 pregnant women between 20th and 40th weeks of gestation admitted to our department were investigated. 63 of them were allocated our preeclampsia group and 53 of them were allocated our control group. Lupus anticoagulant, anti-cardiolipin antibodies (IG G ve M) and antiphosphatidylserine antibodies (IG G ve M) were measured. Results. There was no statistical significance between preeclampsia and control group for antiphospholipid antibodies but these were two times higher in preeclamptic group compared to control group. (22.2% in preeclampsia, 11.3% in control group p=0.193). Conclusions. In an unselected population we were not able to demonstrate an association between preeclampsia and antiphospholipid antibody syndrome but antiphospholipid antibody ratio elevated in women with preeclampsia. These findings show that, there is a need for large scale studies.
Keywords: Preeclampsia, antiphospholipid antibodies, pregnancy
Özet
Amaç. Bu çalışmanın amacı preeklampsi ve antifosfolipid antikor sendromu arasında ilişki olup olmadığının belirlenmesidir. Yöntem. Çalışmaya 20-40 hafta arasındaki toplam 116 gebe katılmıştır. Preeklampsi tanısı alan 63 hasta çalışma grubumuzu oluşturmuştur. Kontrol grubuna sağlıklı, normotensif ve sistemik hastalığı olmayan 53 gebe dahil edilmiştir. Çalışma ve kontrol grubunda bulunan gönüllülerden antifosfolipid antikoru olarak lupus antikoagülan, anti kardiolipin antikorları (IG G ve M) ve antifosfatidilserin antikorları (IG G ve M) çalışılmıştır. Bulgular. Preeklampsi ve konrol grubu arasında antifosfolipid antikor sendromu açısından istatistiksel olarak anlamlı farklılık saptanmamıştır ancak bu antikorlar kontrol grubu ile karşılaştırıldığında, preeklamptik grupta iki kat daha yüksek olarak saptanmıştır. (preeklampside %22,2 kontrol grubunda %11,3) P=0,193. Sonuç. Bu çalışmada preeklampsi ve antifosfolipid antikor sendromu arasında ilişki gösterilememiştir ancak preeklamptik hastalarda antifosfolipid antikorlarının yüksek olarak saptanması daha geniş çaplı ve çalışmalara gereksinim olduğunu göstermektedir.
Anahtar sözcükler: Preeklampsi, gebelik, antifosfolipid antikor sendromuAnahtar Kelimeler
Kaynakça
- Davies JA. Prentice JRM. Coagulation chances in pregnancy-induced hypertension and growth restriction in: Greer IA. Turpie AGG. Forbes CD. Editors. Haemostasis and Thrombosis in Obstetrics and Gynecology London Chapman & Hall 1992; pp: 143-62.
- Duley L. Maternal mortality associated with hypertensive disorders of pregnancy in Africa, Asia, Latin America and the Caribbean. Br J Obstet Gynaecol 1992; 99: 547-53.
- Vormittag R, Pabinger I. Thrombophilia and pregnancy complications. Hamostaseologie 2006; 26: 59-62.
- Levine JS, Branch DW, Rauch J. The antiphospholipid syndrome. N Engl J Med 2002; 346: 752-63.
- Wilson WA, Gharavi AE, Koike T, Lockshin MD, Branch DW, Piette JC, Brey R, Derksen R, Harris EN, Hughes GR, Triplett DA, Khamashta MA. International consensus statement on preliminary classification criteria for definite antiphospholipid syndrome: report of an international workshop. Arthritis Rheum 1999; 42: 1309-11.
- Bick RL, Baker WF Jr. The antiphospholipid and thrombosis syndromes. Med Clin North Am 1994; 78: 667.
- Pattison NS, Chamley LW, McKay EJ, Liggins GC, Butler WS. Antiphospholipid antibodies in pregnancy: prevalence and clinical associations. Br J Obstet Gynaecol 1993; 100: 909-13.
- Yasuda M, Takakuwa K, Tokunaga A, Tanaka K. Prospective studies of the association between anticardiolipin antibody and outcome of pregnancy. Obstet Gynecol 1995; 86: 555-9.
- Branch DW, Andres R, Digre KB, Rote NS, Scott JR. The association of antiphospholipid antibodies with severe preeclampsia. Obstet Gynecol 1989; 73: 541Out HJ, Bruinse HW, Christiaens GC, van Vliet M, de Groot PG, Nieuwenhuis HK, Derksen RH. A prospective, controlled multicenter study on the obstetric risks of pregnant women with antiphospholipid antibodies. Am J Obstet Gynecol 1992; 167: 26-32.
- Matthiesen LS, Berg G, Ernerudh J, Skogh T. A prospective study on the occurrence of autoantibodies in low-risk pregnancies. Eur J Obstet Gynecol Reprod Biol 1999; 83: 21-6.
- Ginsberg JS, Demers C, Brill-Edwards P, Johnston M, Bona R, Burrows RF, Weitz J, Denburg JA. Increased thrombin generation and activity in patients with systemic lupus erythematosus and anticardiolipin antibodies: Evidence for a prothrombotic state. Blood 1993; 81: 2958-63.
- Santoro SA. Antiphospholipid antibodies and thrombotic predisposition: Underlying pathogenetic mechanisms. Blood 1994; 83: 2389-91.
- Rai R, Regan L. Obstetric complications of antiphospholipid antibodies. Curr Opin Obstet Gynaecol 1997; 9: 387-90.
- Milliez J, Lelong F, Bayani N, Jannet D, el Medjadji M, Latrous H, Hammami M, Paniel BJ. The prevalence of autoantibodies during third-trimester pregnancy complicated by hypertension or idiopathic fetal growth retardation. Am J Obstet Gynecol 1991; 165: 51-6.
- Sletnes KE, Wislİff F, Moe N, Dale PO. Antiphospholipid antibodies in preeclamptic women: relation to growth retardation and neonatal outcome. Acta Obstet Gynecol Scand 1992; 71: 112-7.
- Allen JY, Tapia-Santiago C, Kutteh WH. Antiphospholipid antibodies in patients with preeclampsia. Am J Reprod Immunol 1996; 36: 81-5.
- Moodley J, Bhoola V, Duursma J, Pudifin D, Byrne S, Kenoyer DG. The association of antiphospholipid antibodies with severe early-onset pre-eclampsia. S Afr Med J 1995; 85: 105-7. van Pampus MG, Dekker GA, Wolf H, Huijgens PC, Koopman MM, von Blomberg BM, Büller HR. High prevalence of hemostatic abnormalities in women with a history of severe preeclampsia. Am J Obstet Gynecol 1999; 180: 1146Rao AA, Ananthakrishna NC. Anticardiolipin antibodies in eclampsia. Int J Gynaecol Obstet 1992; 38: 37-40.
- Scott RA. Anti-cardiolipin antibodies and pre-eclampsia. Br J Obstet Gynaecol 1987; 94: 604-5.
- Martínez-Abundis E, González-Ortiz M, Cortés-Llamas V, Salazar-Páramo M. Anticardiolipin antibodies and the severity of preeclampsia-eclampsia. Gynecol Obstet Invest 1999; 48: 168-71.
- Redman CW, Sacks GP, Sargent IL. Preeclampsia: an excessive maternal inflammatory response to pregnancy. Am. J Obstet Gynecol 1999; 180: 499-506. Dreyfus M, Hedelin G, Kutnahorsky R, Lehmann M, Viville B, Langer B, Fleury A, M'Barek M, Treisser A, Wiesel ML, Pasquali JL. Antiphospholipid antibodies and preeclampsia: a case-control study. Obstet Gynecol 2001; 97: 29-34.
Öz
Amaç. Bu çalışmanın amacı preeklampsi ve antifosfolipid antikor sendromu arasında ilişki olup olmadığının belirlenmesidir. Yöntem. Çalışmaya 20-40 hafta arasındaki toplam 116 gebe katılmıştır. Preeklampsi tanısı alan 63 hasta çalışma grubumuzu oluşturmuştur. Kontrol grubuna sağlıklı, normotensif ve sistemik hastalığı olmayan 53 gebe dahil edilmiştir. Çalışma ve kontrol grubunda bulunan gönüllülerden antifosfolipid antikoru olarak lupus antikoagülan, anti kardiolipin antikorları (IG G ve M) ve antifosfatidilserin antikorları (IG G ve M) çalışılmıştır. Bulgular. Preeklampsi ve konrol grubu arasında antifosfolipid antikor sendromu açısından istatistiksel olarak anlamlı farklılık saptanmamıştır ancak bu antikorlar kontrol grubu ile karşılaştırıldığında, preeklamptik grupta iki kat daha yüksek olarak saptanmıştır. (preeklampside %22,2 kontrol grubunda %11,3) P=0,193. Sonuç. Bu çalışmada preeklampsi ve antifosfolipid antikor sendromu arasında ilişki gösterilememiştir ancak preeklamptik hastalarda antifosfolipid antikorlarının yüksek olarak saptanması daha geniş çaplı ve çalışmalara gereksinim olduğunu göstermektedir.
Anahtar Kelimeler
Kaynakça
- Davies JA. Prentice JRM. Coagulation chances in pregnancy-induced hypertension and growth restriction in: Greer IA. Turpie AGG. Forbes CD. Editors. Haemostasis and Thrombosis in Obstetrics and Gynecology London Chapman & Hall 1992; pp: 143-62.
- Duley L. Maternal mortality associated with hypertensive disorders of pregnancy in Africa, Asia, Latin America and the Caribbean. Br J Obstet Gynaecol 1992; 99: 547-53.
- Vormittag R, Pabinger I. Thrombophilia and pregnancy complications. Hamostaseologie 2006; 26: 59-62.
- Levine JS, Branch DW, Rauch J. The antiphospholipid syndrome. N Engl J Med 2002; 346: 752-63.
- Wilson WA, Gharavi AE, Koike T, Lockshin MD, Branch DW, Piette JC, Brey R, Derksen R, Harris EN, Hughes GR, Triplett DA, Khamashta MA. International consensus statement on preliminary classification criteria for definite antiphospholipid syndrome: report of an international workshop. Arthritis Rheum 1999; 42: 1309-11.
- Bick RL, Baker WF Jr. The antiphospholipid and thrombosis syndromes. Med Clin North Am 1994; 78: 667.
- Pattison NS, Chamley LW, McKay EJ, Liggins GC, Butler WS. Antiphospholipid antibodies in pregnancy: prevalence and clinical associations. Br J Obstet Gynaecol 1993; 100: 909-13.
- Yasuda M, Takakuwa K, Tokunaga A, Tanaka K. Prospective studies of the association between anticardiolipin antibody and outcome of pregnancy. Obstet Gynecol 1995; 86: 555-9.
- Branch DW, Andres R, Digre KB, Rote NS, Scott JR. The association of antiphospholipid antibodies with severe preeclampsia. Obstet Gynecol 1989; 73: 541Out HJ, Bruinse HW, Christiaens GC, van Vliet M, de Groot PG, Nieuwenhuis HK, Derksen RH. A prospective, controlled multicenter study on the obstetric risks of pregnant women with antiphospholipid antibodies. Am J Obstet Gynecol 1992; 167: 26-32.
- Matthiesen LS, Berg G, Ernerudh J, Skogh T. A prospective study on the occurrence of autoantibodies in low-risk pregnancies. Eur J Obstet Gynecol Reprod Biol 1999; 83: 21-6.
- Ginsberg JS, Demers C, Brill-Edwards P, Johnston M, Bona R, Burrows RF, Weitz J, Denburg JA. Increased thrombin generation and activity in patients with systemic lupus erythematosus and anticardiolipin antibodies: Evidence for a prothrombotic state. Blood 1993; 81: 2958-63.
- Santoro SA. Antiphospholipid antibodies and thrombotic predisposition: Underlying pathogenetic mechanisms. Blood 1994; 83: 2389-91.
- Rai R, Regan L. Obstetric complications of antiphospholipid antibodies. Curr Opin Obstet Gynaecol 1997; 9: 387-90.
- Milliez J, Lelong F, Bayani N, Jannet D, el Medjadji M, Latrous H, Hammami M, Paniel BJ. The prevalence of autoantibodies during third-trimester pregnancy complicated by hypertension or idiopathic fetal growth retardation. Am J Obstet Gynecol 1991; 165: 51-6.
- Sletnes KE, Wislİff F, Moe N, Dale PO. Antiphospholipid antibodies in preeclamptic women: relation to growth retardation and neonatal outcome. Acta Obstet Gynecol Scand 1992; 71: 112-7.
- Allen JY, Tapia-Santiago C, Kutteh WH. Antiphospholipid antibodies in patients with preeclampsia. Am J Reprod Immunol 1996; 36: 81-5.
- Moodley J, Bhoola V, Duursma J, Pudifin D, Byrne S, Kenoyer DG. The association of antiphospholipid antibodies with severe early-onset pre-eclampsia. S Afr Med J 1995; 85: 105-7. van Pampus MG, Dekker GA, Wolf H, Huijgens PC, Koopman MM, von Blomberg BM, Büller HR. High prevalence of hemostatic abnormalities in women with a history of severe preeclampsia. Am J Obstet Gynecol 1999; 180: 1146Rao AA, Ananthakrishna NC. Anticardiolipin antibodies in eclampsia. Int J Gynaecol Obstet 1992; 38: 37-40.
- Scott RA. Anti-cardiolipin antibodies and pre-eclampsia. Br J Obstet Gynaecol 1987; 94: 604-5.
- Martínez-Abundis E, González-Ortiz M, Cortés-Llamas V, Salazar-Páramo M. Anticardiolipin antibodies and the severity of preeclampsia-eclampsia. Gynecol Obstet Invest 1999; 48: 168-71.
- Redman CW, Sacks GP, Sargent IL. Preeclampsia: an excessive maternal inflammatory response to pregnancy. Am. J Obstet Gynecol 1999; 180: 499-506. Dreyfus M, Hedelin G, Kutnahorsky R, Lehmann M, Viville B, Langer B, Fleury A, M'Barek M, Treisser A, Wiesel ML, Pasquali JL. Antiphospholipid antibodies and preeclampsia: a case-control study. Obstet Gynecol 2001; 97: 29-34.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Bölüm | Cerrahi Tıp Bilimleri Araştırma Yazıları |
| Yazarlar | |
| Yayımlanma Tarihi | 22 Mart 2013 |
| Yayımlandığı Sayı | Yıl 2013Cilt: 35 Sayı: 1 |