Primary thrombophilia in México XII: Miscarriages are more frequent in persons with the Sticky Platelet Syndrome (SPS)

Abstract

Objective:Sticky platelet syndrome (SPS) is an inherited condition that leads to arterial and venous thrombosis. There is scant information about the association between SPS and obstetric complications. This study aimed to assess the relationship between SPS and fetal loss at a single institution.Materials and Methods:The obstetric histories of all consecutive female patients prospectively studied in a 324-month period at a single institution with a history of thrombosis and a clinical marker of primary thrombophilia were reviewed.Results:Between 1989 and 2016, 268 consecutive patients with a clinical marker of primary thrombophilia and a history of arterial or venous thrombosis were studied; of these, 108 were female patients. Within this subset of thrombophilic females, 77 (71%) had been pregnant at some point. Twenty-eight of these 77 patients (37%) had had a spontaneous abortion and 24 of those (86%) were found to have SPS. On the other hand, 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%-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).Conclusion:In Mexico, female patients with SPS experience significantly more spontaneous abortions than the general population. Since the treatment of SPS is simple and effective and could in turn prevent adverse obstetric outcomes, its investigation in women treated for obstetric complications may be useful and deserves further research.

Sticky Platelet Syndrome: An Unrecognized Cause of Acute Thrombosis and Graft Loss

“…Described for the first time in the Ninth Stroke and Cerebral Circulation Conference by Holiday et al [ 8 ], the sticky platelet syndrome is defined as a qualitative alteration of the platelet function and of autosomal dominant inheritance, characterized by platelet hyperaggregation in vitro with low concentrations of adenosine diphosphate (ADE) and/or epinephrine (EPI) but with normal aggregation in response to collagen, arachidonic acid, ristocetin, and thrombin [ 9 ].…”

Sticky Platelet Syndrome: 35 Years of Growing Evidence

“…The potentially complex clinical presentation was underscored with description of individuals with both arterial and venous thrombotic events. 40 Apart from stroke and TIA, the first described clinical presentation of the syndrome, and particularly robust evidence with tens of documented cases were provided for pregnancy complications 27,40,46 and classical venous TE. 17,[39][40][41][42] The data for events in other localizations were mostly limited to individual case reports or small case series.…”

“…28 The high prevalence of the syndrome in this particular ethnic group was supported by a more recent study from the same research team. 46 In their retrospective analysis focused on the course of pregnancy in women of Mexican Mestizo origin with known thrombophilia and TE, SPS was found in 73 (67.6%) out of 108 women. Furthermore, 24 (86%) out of 28 women who suffered from spontaneous miscarriage were diagnosed with SPS.…”

Gerinnungsstörungen der Frau

“…Das Sticky-Platelet-Syndrom ist durch eine in vitro vermehrte Thrombozytenaggregation als Reaktion auf ADP und Adrenalin gekennzeichnet und kommt 2-mal häufiger vor im Kollektiv mit idiopathischen arteriellen und venösen Thrombosen im Vergleich zur Allgemeinpopulation. Auch eine Assoziation vom Sticky-Platelet-Syndrom mit Schwangerschaftskomplikationen wurde demonstriert, allerdings in kleinen retrospektiven Studien und Fallberichten [20]. Das in der Schwangerschaft resultierende Ungleichgewicht im Gerinnungssystem führt zur Erhöhung des prokoagulatorischen Plasmapotenzials und begünstigt die Entstehung einer Thromboembolie.…”