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[PMID]: 23313542 [Au] Autor: Thorson CM; Van Haren RM; Ryan ML; Curia E; Sleeman D; Levi JU; Livingstone AS; Proctor KG [Ad] Dirección: Division of Surgical Oncology, Dewitt-Daughtry Family Department of Surgery, University of Miami Miller School of Medicine and Ryder Trauma Center, Miami, FL 33136, USA. [Ti] Título: Persistence of hypercoagulable state after resection of intra-abdominal malignancies. [So] Fuente: J Am Coll Surg;216(4):580-9; discussion 589-90, 2013 Apr. [Is] ISSN: 1879-1190 [Cp] País de publicación: United States [La] Idioma: eng [Ab] Resumen: BACKGROUND: The hypercoagulable state associated with cancer imparts considerable risk for venous thromboembolism. Surgical resection of malignancies should theoretically reverse tumor-induced hypercoagulability. However, coagulation changes in cancer patients postresection have not been described thoroughly. Conventional coagulation tests are unable to detect hypercoagulable states. In contrast, rotational thromboelastography (ROTEM) can detect hypo- or hypercoagulable conditions. We hypothesized that the cancer-induced hypercoagulable state would improve after surgical resection. METHODS: After informed consent, blood samples of patients undergoing surgical resection for curative intent were analyzed with serial ROTEM. RESULTS: Thirty-five patients (mean ± SD age 66 ± 17 years; 67% male) had cancers involving the pancreas (n = 12 [34%]), esophagus (n = 10 [29%]), stomach (n = 7 [20%]), bile ducts (n = 3 [9%]), and duodenum (n = 3 [9%]). Preoperative ROTEM identified 14 (40%) who were hypercoagulable. After surgical resection, patients became progressively hypercoagulable with more rapid clot formation time (low clot formation time, high alpha) and higher maximum clot firmness. By week one, 86% (n = 30) had abnormal ROTEM values, including 17 of 21 (81%) who had normal coagulation profiles preoperatively. Most (n = 30 [86%]) remained hypercoagulable at 3 to 4 weeks. CONCLUSIONS: Rotational thromboelastography identifies baseline hypercoagulability in more than one third of patients with intra-abdominal malignancies. This is among the first studies to demonstrate progressive hypercoagulability that persists for at least 1 month after resection. These data support postdischarge thromboprophylaxis regimens in high-risk cancer patients. [Mh] Términos MeSH primario: Neoplasias Abdominales/cirugía Tromboelastografía Trombofilia/diagnóstico Trombofilia/epidemiología [Mh] Términos MeSH secundario: Adulto Anciano Anciano de 80 o más Años Femenino Humanos Masculino Mediana Edad Estudios Prospectivos Trombofilia/prevención & control [Pt] Tipo de publicación: JOURNAL ARTICLE; RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S. [Em] Mes de ingreso: 1305 [Sb] Subgrupo de revista: AIM; IM [Da] Fecha de ingreso para procesamiento: 130325 [St] Status: MEDLINE

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[PMID]: 23052827 [Au] Autor: Steinvil A; Raz R; Berliner S; Steinberg DM; Zeltser D; Levran D; Shimron O; Sella T; Chodick G; Shalev V; Salomon O [Ad] Dirección: Departments of Internal Medicine D and E, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. [Ti] Título: Association of common thrombophilias and antiphospholipid antibodies with success rate of in vitro fertilisation. [So] Fuente: Thromb Haemost;108(6):1192-7, 2012 Dec. [Is] ISSN: 0340-6245 [Cp] País de publicación: Germany [La] Idioma: eng [Ab] Resumen: Assisted reproductive technology (ART) is extensively used as a tool for pregnancy achievement in subfertile couples. Congenital and acquired thrombophilias have been suggested by some investigators to play a role in abnormal embryo implantation and placentation. The objective of this study was to assess the role of common thrombophilias in women with unexplained infertility undergoing in vitro fertilisation (IVF). We retrospectively analysed 594 women from a large healthcare maintenance organisation going through IVF and who had a thrombophilia workup, and compared them for prevalence of thrombophilia to two reference groups consisting of 637 fertile women from previous work and 17,337 women members of the same healthcare organisation with no history of venous thromboembolism. The mean age of the women at the first cycle of IVF was 30.9 years (SD: 4.1).The mean number of IVF cycles was 7.3 (SD: 5.0), and the mean fertility success rate per woman was 14.6% (SD: 19.0%). None of the common thrombophilias tested was found to be significantly associated with the number of IVF cycles or with lower fertility success rate. Rather, women who had APCR and /or factor V Leiden and lupus anticoagulant had significantly higher live birth rates (12.3% and 12.6%, respectively) in comparison to women who were tested negative (9.0% and 9.7%, respectively). Thus, hypercoagulability is not associated with failure to achieve pregnancy. These data suggest that neither screening for thrombophilia nor anticoagulant treatment is indicated in cases with unexplained reproductive failure. [Mh] Términos MeSH primario: Anticuerpos Antifosfolípidos/sangre Fertilización In Vitro Infertilidad/sangre Infertilidad/complicaciones Trombofilia/complicaciones [Mh] Términos MeSH secundario: Resistencia a la Proteína C Activada/sangre Resistencia a la Proteína C Activada/complicaciones Adulto Factor V/genética Factor V/metabolismo Femenino Humanos Recién Nacido Infertilidad/inmunología Masculino Embarazo Resultado del Embarazo Protrombina/genética Protrombina/metabolismo Estudios Retrospectivos Trombofilia/sangre Insuficiencia del Tratamiento Resultado del Tratamiento [Pt] Tipo de publicación: JOURNAL ARTICLE [Nm] Nombre de substancia: 0 (Antibodies, Antiphospholipid); 0 (factor V Leiden); 9001-24-5 (Factor V); 9001-26-7 (Prothrombin) [Em] Mes de ingreso: 1305 [Sb] Subgrupo de revista: IM [Da] Fecha de ingreso para procesamiento: 121130 [St] Status: MEDLINE [do] DOI: 10.1160/TH12-06-0381

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[PMID]: 22872143 [Au] Autor: Kyrle PA; Eichinger S [Ad] Dirección: Dept. of Medicine I, Medical University of Vienna, Vienna, Austria. paul.kyrle@meduniwien.ac.at [Ti] Título: Clinical scores to predict recurrence risk of venous thromboembolism. [So] Fuente: Thromb Haemost;108(6):1061-4, 2012 Dec. [Is] ISSN: 0340-6245 [Cp] País de publicación: Germany [La] Idioma: eng [Ab] Resumen: Venous thromboembolism (VTE) is a common and chronic disease with a considerable risk of recurrence. Patients with unprovoked (in the absence of a transient risk factor) VTE have a recurrence risk as high as 30% within five years after cessation of anticoagulation. Depending on patient selection the case-fatality rate of recurrence ranges between 3.6%-10%. Thus, indefinite anticoagulation treatment should be considered in these patients. However, anticoagulation confers a considerable risk of bleeding (fatal bleedings 0.1%-0.5%/year). It is therefore of utmost clinical importance to identify those patients, who will not benefit from indefinite anticoagulation, i.e. patients, in whom the bleeding risk during anticoagulant treatment is higher than the risk of recurrence. Several attempts to discriminate patients with a high from those with a low risk of recurrence including screening for acquired and inherited thrombotic risk factors or measurement of coagulation activation markers have either failed (thrombophilia screening) or were of moderate success (stratification according to D-dimer only). A novel approach for assessing risk of recurrent VTE consists of linking clinical patient characteristics with laboratory testing. Several such scoring models which can be used to assess the risk of recurrent VTE have been developed and await prospective validation before they can be applied in daily routine care. The aim of this report is to describe currently available scoring systems in more detail. [Mh] Términos MeSH primario: Tromboembolia Venosa/etiología [Mh] Términos MeSH secundario: Anticoagulantes/uso terapéutico Marcadores Biológicos/sangre Femenino Productos de Degradación de Fibrina-Fibrinógeno/análisis Humanos Masculino Modelos Cardiovasculares Recurrencia/prevención & control Factores de Riesgo Trombofilia/diagnóstico Tromboembolia Venosa/quimioterapia Tromboembolia Venosa/prevención & control [Pt] Tipo de publicación: JOURNAL ARTICLE; REVIEW [Nm] Nombre de substancia: 0 (Anticoagulants); 0 (Biological Markers); 0 (Fibrin Fibrinogen Degradation Products); 0 (fibrin fragment D) [Em] Mes de ingreso: 1305 [Sb] Subgrupo de revista: IM [Da] Fecha de ingreso para procesamiento: 121130 [St] Status: MEDLINE [do] DOI: 10.1160/TH12-05-0353

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[PMID]: 22933620 [Au] Autor: Carrera-Marín A; Romay-Penabad Z; Papalardo E; Reyes-Maldonado E; García-Latorre E; Vargas G; Shilagard T; Pierangeli S [Ad] Dirección: Division of Rheumatology, University of Texas Medical Branch, Galveston, TX 77555, USA. [Ti] Título: C6 knock-out mice are protected from thrombophilia mediated by antiphospholipid antibodies. [So] Fuente: Lupus;21(14):1497-505, 2012 Dec. [Is] ISSN: 1477-0962 [Cp] País de publicación: England [La] Idioma: eng [Ab] Resumen: BACKGROUND: Complement activation plays a role in pathogenesis of the antiphospholipid syndrome (APS), but the involvement of the C5b-9 membrane attack complex (MAC) is unknown. Here we studied the effects of human polyclonal antiphospholipid (aPL) antibodies on thrombosis and tissue factor (TF) up-regulation in C6 deficient (C6(-/-)) mice. METHODS: C6(-/-) mice or the wild-type C3H/HeJ (C6(+/+)) mice were injected twice with IgG-APS (n = 2) or IgM-APS (n = 1) isolated from APS patients or with the corresponding control immunoglobulins (Igs) of normal human serum, (NHS) (IgG-NHS or IgM-NHS). Then, the sizes of induced thrombi in the femoral vein were determined 72 hours after the first injection. Tissue factor was determined in homogenates of carotid arteries and in peritoneal macrophages. RESULTS: Thrombus sizes were significantly larger in C6(+/+) treated with IgG-APS1 or with IgG-APS2 or with IgM-APS when compared with C6(+/+) mice treated with IgG-NHS or with IgM-NHS, respectively. The sizes of thrombi were significantly smaller in the C6(-/-) mice injected with IgG-APS1, IgG-APS2 or IgM-APS (p < 0.001), compared to their C6(+/+) counterparts showing an important abrogation of thrombus formation in mice lacking C6. The TF expression and activity in the C6(-/-) mice treated with IgG-APS or IgM-APS were diminished when compared to C3H/HeJ (C6(+/+)) mice treated with the same Igs. All mice injected with IgG-APS and IgM-APS had medium-high titers of anticardiolipin (aCL) and anti-ß(2)glycoprotein I (aß(2)GPI) antibodies. CONCLUSIONS: These data indicate that the C6 component of the complement system mediates aPL-thrombogenic effects, underscoring an important pathogenic mechanism and indicating the possibility of inhibiting complement to ameliorate APS-related manifestations. [Mh] Términos MeSH primario: Anticuerpos Antifosfolípidos/inmunología Síndrome Antifosfolípido/inmunología Complemento C6/genética Trombofilia/inmunología [Mh] Términos MeSH secundario: Adulto Animales Arterias Carótidas/metabolismo Femenino Vena Femoral Humanos Inmunoglobulina G/inmunología Inmunoglobulina M/inmunología Macrófagos Peritoneales/metabolismo Masculino Ratones Ratones Consanguíneos C3H Ratones Noqueados Mediana Edad Tromboplastina/inmunología Trombosis/inmunología Trombosis/patología Regulación hacia Arriba/inmunología [Pt] Tipo de publicación: JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T [Nm] Nombre de substancia: 0 (Antibodies, Antiphospholipid); 0 (Complement C6); 0 (Immunoglobulin G); 0 (Immunoglobulin M); 9035-58-9 (Thromboplastin) [Em] Mes de ingreso: 1305 [Sb] Subgrupo de revista: IM [Da] Fecha de ingreso para procesamiento: 121119 [St] Status: MEDLINE [do] DOI: 10.1177/0961203312458839

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[PMID]: 23216595 [Au] Autor: Ortel TL; Kitchens CS; Erkan D; Brandão LR; Hahn S; James AH; Kulkarni R; Manco-Johnson MJ; Pericak-Vance M; Vance J [Ad] Dirección: Hemostasis and Thrombosis Center, Duke University Medical Center, Durham, NC 27710, USA. thomas.ortel@duke.edu [Ti] Título: Clinical causes and treatment of the thrombotic storm. [So] Fuente: Expert Rev Hematol;5(6):653-9, 2012 Dec. [Is] ISSN: 1747-4094 [Cp] País de publicación: England [La] Idioma: eng [Ab] Resumen: Thrombotic storm represents an extreme prothrombotic phenotype, characterized by multiple thrombotic events affecting diverse vascular beds occurring over a brief period of time. Thrombotic events involve venous and arterial circulation, including unusual locations, such as cerebral sinus venous thrombosis, intra-abdominal thromboembolic occlusions and microvascular events. Some patients will have antiphospholipid antibodies, but a significant number have no identifiable hypercoagulable state. The mainstay of treatment consists of anticoagulant therapy, although some patients appear to benefit from the addition of immunomodulatory therapies. Other disorders that share this thrombotic storm phenotype include catastrophic antiphospholipid syndrome, spontaneous heparin-induced thrombocytopenia and similar aggressive clinical disorders. Ongoing studies are focused on identifying underlying genetic factors that may predispose patients to develop this extreme clinical phenotype. [Mh] Términos MeSH primario: Anticoagulantes/uso terapéutico Trombofilia/quimioterapia Trombofilia/patología Trombosis/quimioterapia Trombosis/patología [Mh] Términos MeSH secundario: Humanos [Pt] Tipo de publicación: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW [Nm] Nombre de substancia: 0 (Anticoagulants) [Em] Mes de ingreso: 1305 [Sb] Subgrupo de revista: IM [Da] Fecha de ingreso para procesamiento: 121211 [St] Status: MEDLINE [do] DOI: 10.1586/ehm.12.56

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[PMID]: 22792766 [Au] Autor: Yin W; Sheng J [Ad] Dirección: Department of Orthopedics, the Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, 200233, P.R.China. [Ti] Título: [Progress in relationship between heritable hypercoagulable state and avascular necrosis of femoral head]. [So] Fuente: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi;26(6):695-8, 2012 Jun. [Is] ISSN: 1002-1892 [Cp] País de publicación: China [La] Idioma: chi [Ab] Resumen: OBJECTIVE: To review the relationship between heritable hypercoagulable state (HHCS) and avascular necrosis of femoral head (ANFH). METHODS: The latest original articles about the relationship between HHCS and ANFH were extensively reviewed. RESULTS: Several genetic mutations which could cause HHCS, such as thrombophilic factor V G1691A gene, thrombophilic factor II G20210A gene, 5, 10-methylenetetrahydrofolate reductase C677T gene, plasminogen activator inhibitor 1 4G/5G, and tissue factor pathway inhibitor gene, may be genetic risks of ANFH. CONCLUSION: HHCS may be a genetic cause of ANFH. Further studies are needed to confirm the relationship between HHCS and Chinese ANFH. [Mh] Términos MeSH primario: Factor V/genética Necrosis de la Cabeza Femoral/genética Mutación Protrombina/genética Trombofilia/genética [Mh] Términos MeSH secundario: Necrosis de la Cabeza Femoral/etiología Predisposición Genética a la Enfermedad Genotipo Humanos Metilenotetrahidrofolato Reductasa (NADPH2)/genética Inhibidor 1 de Activador Plasminogénico/genética Polimorfismo Genético Factores de Riesgo Trombofilia/complicaciones [Pt] Tipo de publicación: ENGLISH ABSTRACT; JOURNAL ARTICLE; REVIEW [Nm] Nombre de substancia: 0 (Plasminogen Activator Inhibitor 1); 9001-24-5 (Factor V); 9001-26-7 (Prothrombin); EC 1.5.1.20 (Methylenetetrahydrofolate Reductase (NADPH2)) [Em] Mes de ingreso: 1305 [Sb] Subgrupo de revista: IM [Da] Fecha de ingreso para procesamiento: 120716 [St] Status: MEDLINE

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[PMID]: 22660949 [Au] Autor: Bracaglia R; Tambasco D; D'ettorre M; Gentileschi S [Ad] Dirección: Department of Plastic and Reconstructive Surgery, Catholic University of the Sacred Heart, Largo A. Gemelli, Rome, Italy. [Ti] Título: Management of patients undergoing rhinoplasty while receiving anticoagulant therapy. [So] Fuente: Aesthetic Plast Surg;36(5):1087-9, 2012 Oct. [Is] ISSN: 1432-5241 [Cp] País de publicación: United States [La] Idioma: eng [Ab] Resumen: A proper bloodless field and coagulation profile represent essential elements for performing a safe, effective, and fast rhinoplasty. However, some particular conditions among patients with a high thromboembolic risk for congenital thrombophilia require antithrombotic prophylaxis using low-molecular-weight heparin. To date, the literature contains no particular indication for the management of patients undergoing rhinoseptoplasty while receiving anticoagulant therapy. The authors report their experience managing a 36-year-old man who underwent aesthetic rhinoseptoplasty while at the same time carrying a heterozygous mutation (G20210A) of prothrombin and a homozygous mutation of methylenetetrahydrofolate reductase (C677T). Special attention must be paid to balancing the prevention and reduction of thrombotic risk for excessive anticoagulation, which would make surgery unsafe and difficult to perform. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. [Mh] Términos MeSH primario: Anticoagulantes/uso terapéutico Rinoplastia [Mh] Términos MeSH secundario: Adulto Humanos Masculino Metilenotetrahidrofolato Reductasa (NADPH2)/genética Mutación Protrombina/genética Factores de Riesgo Trombofilia/quimioterapia Trombofilia/genética [Pt] Tipo de publicación: CASE REPORTS; JOURNAL ARTICLE [Nm] Nombre de substancia: 0 (Anticoagulants); 9001-26-7 (Prothrombin); EC 1.5.1.20 (Methylenetetrahydrofolate Reductase (NADPH2)) [Em] Mes de ingreso: 1305 [Sb] Subgrupo de revista: IM [Da] Fecha de ingreso para procesamiento: 121119 [St] Status: MEDLINE [do] DOI: 10.1007/s00266-012-9922-1

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[PMID]: 23146054 [Au] Autor: Cappellini MD; Poggiali E; Taher AT; Musallam KM [Ad] Dirección: Department of Internal Medicine, IRCCS Ca' Granda Foundation Maggiore Policlinico Hospital, University of Milan, Milan, Italy. maria.cappellini@unimi.it [Ti] Título: Hypercoagulability in ß-thalassemia: a status quo. [So] Fuente: Expert Rev Hematol;5(5):505-11; quiz 512, 2012 Oct. [Is] ISSN: 1747-4094 [Cp] País de publicación: England [La] Idioma: eng [Ab] Resumen: Life expectancy of thalassemia patients has markedly improved over the last few decades, but patients still suffer from many complications of their congenital chronic disease, and several new complications are now being acknowledged, including thrombosis. The high prevalence of thromboembolic events, especially in thalassemia intermedia, has led to the identification of a hypercoagulable state in these patients. This review summarizes current knowledge of the clinical and pathophysiological characteristics of hypercoagulability in thalassemia patients. Strategies to prevent thrombotic events are also discussed. [Mh] Términos MeSH primario: Trombofilia/fisiopatología Talasemia beta/complicaciones [Mh] Términos MeSH secundario: Humanos Agregación Plaquetaria Especies de Oxígeno Reactivo/metabolismo Factores de Riesgo Trombofilia/complicaciones Trombofilia/epidemiología Talasemia beta/metabolismo [Pt] Tipo de publicación: JOURNAL ARTICLE; REVIEW [Nm] Nombre de substancia: 0 (Reactive Oxygen Species) [Em] Mes de ingreso: 1305 [Sb] Subgrupo de revista: IM [Da] Fecha de ingreso para procesamiento: 121113 [St] Status: MEDLINE [do] DOI: 10.1586/ehm.12.42

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[PMID]: 22524536 [Au] Autor: Demirel G; Celik IH; Zergeroglu S; Erdeve O; Dilmen U [Ad] Dirección: Zekai Tahir Burak Maternity Teaching Hospital, Division of Neonatology, Ankara, Turkey. kgamze@hotmail.com [Ti] Título: Neonatal outcome of the pregnancies associated with placental villous thrombosis - thrombophilic status of the mothers and the infants. [So] Fuente: J Matern Fetal Neonatal Med;25(11):2225-9, 2012 Nov. [Is] ISSN: 1476-4954 [Cp] País de publicación: England [La] Idioma: eng [Ab] Resumen: OBJECTIVE: To analyze the relationship of obstetric complications and neonatal outcomes with the thrombophilic status of the mother-infant couples in case of demonstrated placental villous thrombosis in histopathological evaluation after delivery. METHODS: Placentas of high-risk pregnancies, unexplained fetal loss or infants who needed neonatal intensive care unit (NICU) admission were collected at the time of delivery. RESULTS: In a 6 months period, placental villous thrombosis was detected in 30 among 800 placentas. Half of the mothers had a bad obstetric outcome previously, such as at least one abortus or stillbirth. Eighteen neonates (60%) were premature. Seventy-five percent of the neonates (n = 24) needed NICU admission and the mortality rate was 9.3 %. Five of the patients had congenital anomalies. Thrombophilic mutations could be evaluated in seven mothers-infant couples, all of whom had at least one positive mutation for thrombosis. CONCLUSIONS: Severe fetal vasculopathy appears to be a predisposing factor for adverse neonatal outcomes. Analyzing placentas will yield advantages as the same pathological process may repeat in subsequent pregnancies. Thrombophilic mutations should be evaluated to provide the etiology of the adverse outcome and to give prophylaxis for the future pregnancies. [Mh] Términos MeSH primario: Enfermedades Placentarias/diagnóstico Complicaciones Hematológicas del Embarazo/epidemiología Resultado del Embarazo/epidemiología Trombosis/diagnóstico [Mh] Términos MeSH secundario: Adulto Vellosidades Coriónicas/patología Femenino Humanos Recién Nacido/sangre Recién Nacido/fisiología Enfermedades del Recién Nacido/diagnóstico Enfermedades del Recién Nacido/epidemiología Masculino Madres/estadística & datos numéricos Enfermedades Placentarias/epidemiología Enfermedades Placentarias/patología Embarazo Complicaciones Hematológicas del Embarazo/diagnóstico Pronóstico Trastornos Puerperales/diagnóstico Trastornos Puerperales/epidemiología Trombofilia/diagnóstico Trombofilia/epidemiología Trombofilia/patología Trombosis/epidemiología Trombosis/patología [Pt] Tipo de publicación: JOURNAL ARTICLE [Em] Mes de ingreso: 1304 [Sb] Subgrupo de revista: IM [Da] Fecha de ingreso para procesamiento: 121015 [St] Status: MEDLINE [do] DOI: 10.3109/14767058.2012.684169

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[PMID]: 22506595 [Au] Autor: Derbent AU; Yanik FF; Inegöl Gümüs I; Simavli S; Turhan NÖ [Ad] Dirección: Department of Obstetrics and Gynecology, Fatih University School of Medicine, Ankara, Turkey. ayseluysal@hotmail.com [Ti] Título: Impact of inherited thrombophilias on first and second trimester maternal serum markers for aneuploidy. [So] Fuente: J Matern Fetal Neonatal Med;25(11):2177-81, 2012 Nov. [Is] ISSN: 1476-4954 [Cp] País de publicación: England [La] Idioma: eng [Ab] Resumen: OBJECTIVE: To evaluate first and second-trimester maternal serum markers in pregnancies complicated with inherited thrombophilias. METHODS: A case-control study was conducted in 50 pregnancies complicated with hereditary thrombophilia and 100 control pregnancies. RESULTS: Each woman with inherited thrombophilia received low molecular weight heparin (LMWH) throughout her pregnancy. Gravidity, parity, number of first-trimester and second-trimester abortions, and rate of adverse pregnancy outcomes (APO) were significantly higher in the thrombophilia group compared to the control group (P < 0.001 for all). Among the thrombophilia group median values of pregnancy associated placental protein-A (PAPP-A) (0.6 vs. 0.9; P < 0.001) and free ß-human chorionic gonadotropin (ß-hCG) (0.9 vs. 1.1; P = 0.001) in the first trimester; median values of α-fetoprotein (AFP) (0.7 vs. 1.1; P = 0.027), unconjugated estriol 3 (uE3) (0.9 vs. 1.1; P < 0.001), and hCG (0.7 vs. 1.2; P < 0.001) in the second trimester were significantly lower with respect to control pregnancies. Multivariate analysis revealed that low uE3 and hCG levels were independently associated with APO. CONCLUSION: Pregnant women with hereditary thrombophilias, all of whom were treated with LMWH, had decreased levels of all first and second trimester serum markers. In addition, levels of hCG and uE3 in the second trimester could independently predict placenta-related disorders and adverse outcomes in these patients. [Mh] Términos MeSH primario: Aneuploidia Marcadores Biológicos/sangre Complicaciones Hematológicas del Embarazo/sangre Primer Trimestre del Embarazo/sangre Segundo Trimestre del Embarazo/sangre Diagnóstico Prenatal Trombofilia/sangre [Mh] Términos MeSH secundario: Adulto Marcadores Biológicos/análisis Análisis Químico de la Sangre/normas Estudios de Casos y Controles Femenino Humanos Masculino Valor Predictivo de las Pruebas Embarazo Diagnóstico Prenatal/métodos Estudios Retrospectivos [Pt] Tipo de publicación: EVALUATION STUDIES; JOURNAL ARTICLE [Nm] Nombre de substancia: 0 (Biological Markers) [Em] Mes de ingreso: 1304 [Sb] Subgrupo de revista: IM [Da] Fecha de ingreso para procesamiento: 121015 [St] Status: MEDLINE [do] DOI: 10.3109/14767058.2012.684105

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