Display options
Share it on

J Lab Physicians. 2012 Jul;4(2):78-82. doi: 10.4103/0974-2727.105586.

Antiphospholipid antibodies in iraqi women with recurrent mid-trimester abortions.

Journal of laboratory physicians

Amel Aa Al Samarrai, Ferial A Hilmi, Nasir As Al-Allawi, Amal F Murad

Affiliations

  1. Department of Laboratory, Children Welfare Hospital, Baghdad, Iraq.

PMID: 23440942 PMCID: PMC3574502 DOI: 10.4103/0974-2727.105586

Abstract

PURPOSE: Antiphospholipid antibodies are often associated with recurrent pregnancy loss, and although many studies have addressed this association in Western countries, such studies are not so frequent from developing countries. The current study aims to determine the frequency of Antiphospholipid antibodies (Anticardiolipin antibodies and Lupus anticoagulant) among Iraqi women with recurrent mid-trimester abortions and to evaluate various tests used for their detection.

MATERIALS AND METHODS: Two hundred women with recurrent mid-trimester abortions were randomly enrolled from a main referral center in Baghdad-Iraq. The enrollees had their IgG and IgM anticardiolipin antibodies assayed by ELISA, and Lupus anticoagulant by a combination of the following screening tests : Activated Partial Thromboplastine Time (APTT), and Partial Thromboplastine Time-LA (PTT-LA), Kaolin Clotting Time (KCT) and confirmation was made by Hexagonal phospholipid neutralization test.

RESULTS: The women were aged between 19 and 45 years (median 30 years). Fifty three (26.5%) had one or both anticardiolipin antibodies present, while 27 (13.5%) were positive for lupus anticoagulant. The KCT and KCT index appeared to be the most sensitive tests, while the KCT index and APTT were the most specific for Lupus anticoagulant. Patients with antiphospholipid antibodies had higher rates of history of thrombosis, thrombocytopenia and family history of recurrent abortion (P = 0.0009, 0.0056 and 0.0003 respectively).

CONCLUSIONS: Antiphospholipid antibodies constitute an important cause of recurrent mid-trimester abortion in Iraqi women, with frequencies intermediate between Western and Indian reports. While thrombocytopenia and thrombosis are well documented associations of antiphospholipid antibodies, the significant association with family history of recurrent fetal loss is intriguing and requires further scrutiny.

Keywords: Anticardiolipin antibodies; Iraq; antiphospholipid antibodies; lupus anticoagulant; recurrent abortion

References

  1. J Rheumatol. 2006 Nov;33(11):2214-21 - PubMed
  2. Thromb Haemost. 1988 Oct 31;60(2):217-9 - PubMed
  3. Obstet Gynecol. 1991 Jun;77(6):854-8 - PubMed
  4. Ann Rheum Dis. 1991 Aug;50(8):553-7 - PubMed
  5. Arthritis Rheum. 2012 Jan;64(1):1-10 - PubMed
  6. Obstet Gynecol. 1996 Apr;87(4):489-93 - PubMed
  7. Clin Chem. 2007 Sep;53(9):1629-35 - PubMed
  8. Ann Rheum Dis. 2005 Dec;64(12):1671-6 - PubMed
  9. Arthritis Rheum. 1982 Nov;25(11):1271-7 - PubMed
  10. Clin Obstet Gynecol. 2001 Mar;44(1):2-10 - PubMed
  11. Acta Med Scand. 1975 Mar;197(3):153-9 - PubMed
  12. J Postgrad Med. 2011 Jan-Mar;57(1):3 - PubMed
  13. J Postgrad Med. 2002 Jan-Mar;48(1):5-10 - PubMed
  14. Biologics. 2008 Dec;2(4):897-902 - PubMed
  15. Br J Haematol. 1978 Sep;40(1):143-51 - PubMed
  16. Nat Rev Rheumatol. 2011 Jun;7(6):330-9 - PubMed
  17. J R Coll Physicians Lond. 1994 Jul-Aug;28(4):301-4 - PubMed
  18. Clin Obstet Gynecol. 1994 Sep;37(3):745-60 - PubMed

Publication Types