Reply to Comment on: Inherited Thrombophilia and Pregnancy Complications: Should We
Test?
I read the paper by Arachchillage and Makris, entitled “Inherited Thrombophilia and
Pregnancy Complications: Should We Test,” with interest.[1] The paper deals with several inherited thrombophilic conditions which may lead to
obstetric complications and concludes that no thrombophilia tests are necessary in
the study of a person with pregnancy complications.[1] Interestingly, the paper overlooks one inherited thrombophilic condition which may
lead to obstetric complications: the sticky platelet syndrome (SPS).[2] We[2]
[3] and others[2] have shown that SPS may lead to recurrent abortions and other obstetric complications.[2] We studied a group of 108 women with a clinical marker of thrombophilia and a history
of venous or arterial thrombosis in which 77 (71%) had been pregnant at some point
in time. Twenty-eight of these 77 patients (37%) had had a spontaneous abortion and
24 of those (86%) were found to have SPS. Moreover, in a subset of 73 female patients
with SPS who had been pregnant, 32% had miscarriages. These figures are significantly
higher than the prevalence of spontaneous abortions in the general Mexican population
of pregnant women, which is 12 to 13% (Chi-square: 7.47; p = 0.0063). Accordingly, the relative risk of having a miscarriage is 2.66 times higher
in female patients with SPS than in the general population (p = 0.0014). We concluded that in Mexico, female patients with SPS experience significantly
more spontaneous abortions than the general population. Since the treatment of SPS
is simple and effective (involving antiplatelet agents, such as aspirin) and could
in turn prevent adverse obstetric outcomes, its investigation in women studied for
obstetric complications may be useful and deserves further research.
Accordingly, we and others[2]
[3]
[4]
[5] think that the investigation of SPS in women, experiencing obstetric complications,
should be undertaken and that adequate treatment may enable prevention of further
obstetric complications.
