Inherited Risk Factors for Hemorrhagic Complications in the 1st Trimester of Pregnancy
Purpose: The purpose of the study was to assess the role of genetic risk factors in the development of retrochorial hematoma.
Materials and methods: Genotyping of four polymorphisms of the folate cycle (MTHFR C677T, MTHFR A1298C, MTR A2756G, MTRR A66G) and eight polymorphisms of hemostasis system (F2 G20210A, F5 G1691A, F7 G10976A, F13 G103T, FGB G-455A, ITGA2 C807T, ITGB3 T1565S, SERPINE1-675 5G/4G) was performed to identify genetic risk factors of retrochorial hematoma accompanied by bleeding in the I trimester of pregnancy. The study was conducted among 238 pregnant women with retrochorial hematoma and 67 pregnant women without retrochorial hematoma.
Results: The risk of retrochorial hematoma increases in the presence of rare alleles of polymorphic loci of proconvertin F7 gene (sensitivity 62,61 (56,12-68,77), specificity 16,42 (8,49-27,48), PPV 72,68 (66,04-78,66)) and fibrin stabilizing factor F13 gene (sensitivity 73,11 (67-78,63), specificity 5,97 (1,65-14,59), PPV 73,42 (67,31-78,93)), while the presence of polymorphic alleles of these genes in homozygous state is the most unfavorable combination. The chance of developing a retrochorial hematoma increases 5.5 times with the combination of F7 G10976A (genotype G/A and A/A) and F 13 G103T (genotype G/T and T/T).
Conclusion: Since the genotype G/A or A/A of G10976A F7 gene polymorphism and genotype G/T or T/T of G103T F13 polymorphism are associated with a predisposition to hypocoagulation.