For patients with recurrent pregnancy loss
Protein C, Protein S, antithrombin and coagulation factor XII activity do not need to be measured.
APS is thought to be caused by a blood clot in the placenta, which impairs the flow of blood, resulting in miscarriage and stillbirth. Likewise, it was thought that patients with congenital protein C, protein S, and antithrombin deficiency, all of which are clotting inhibitors, may be more prone to thrombosis (thrombotic predisposition) and may use the same mechanism in miscarriage and stillbirth as in APS. However, this theory does not explain the majority of miscarriages, as they occur before the placenta is formed. Antiphospholipid antibodies are also involved in early miscarriages because they inhibit the growth of the villi, which are the source of the placenta, and are not related to a blood clot at this stage.
When both protein S activity and genes were examined and treated, no improvement was noted (21). The European Society for Reproductive Medicine, the American Society for Reproductive Medicine, the American College of Obstetricians and Gynecologists, and the American College of Thoracic Surgeons have all stated that they do not recommend testing for a thrombotic predisposition as a way of predicting pregnancy complications (1).
- Definition of recurrent miscarriage and recurrent pregnancy loss and results of the Japan Environment and Children’s Study (JECS)
- Examination and causes of RPL
- Antiphospholipid syndrome
- Treatment of antiphospholipid syndrome
- Chromosomal translocation in either partner
- Preimplantation genetic testing for chromosomal structural rearrangement
- Congenital uterine anomaly
- Thrombotic predisposition
- Endocrine abnormality
- Fetal or embryonic aneuploidy
- Preimplantation genetic testing for aneuploidy
- Immunotherapy for unexplained recurrent miscarriage
- Drug administration for repeated miscarriages of unknown cause
- Unknown Causes
- Emotional support