The significance of thrombophilia as a risk factor of fetal loss syndrome

Despite significant advancements in modern obstetrics in understanding the factors contributing to perinatal loss and associated pathologies, the role of hemostatic disorders in pregnant women remains insufficiently studied. Aim - to study the frequency and spectrum of thrombophilic disorders in patients with fetal loss syndrome (FLS). Materials and methods. A retrospective cohort study was conducted involving 83 women of reproductive age (21 to 42 years; mean age: 30.86±5.02 years) with a history of fetal loss syndrome who sought medical care at obstetric and gynecological hospitals in Vinnytsia between 2017 and 2022. Reproductive function was studied: age at menarche, somatic, gynecological, and obstetric history, and the results of thrombophilia gene polymorphism studies. Genetic forms of thrombophilia were identified using the polymerase chain reaction (PCR) method. Statistical analysis of the data was performed using the "SPSS 21" software. Results. Thrombophilia was identified in the majority of patients with fetal loss syndrome (66.3%), accounting for 63.3% of cases in patients with early miscarriages, 65% in late miscarriages, and 66.7% in cases of antenatal or early neonatal fetal death. The most common forms of thrombophilia in patients with FLS included heterozygous polymorphism of PAI-1 (43.6%), circulating antiphospholipid antibodies (34.5%), heterozygous mutation of Factor V (14.5%), and fibrinogen polymorphism (14.5%). It was determined that the most common form of thrombophilia among women with early miscarriages was antiphospholipid syndrome, whereas in women with late miscarriages, genetic forms of thrombophilia predominated. Conclusions. Given the pathogenic role of genetic and acquired defects in the hemostatic system in the development of reproductive losses, women with a history of fetal loss syndrome should be screened for thrombophilia. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the author.