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Geburtshilfe Frauenheilkd 2000; 60(2): 95-100
DOI: 10.1055/s-2000-5987
ORIGINALARBEIT
Georg Thieme Verlag Stuttgart · New York

Antiphospholipid-Antikörper und andere hämostaseologische Veränderungen bei Patientinnen mit früher schwerer Präeklampsie oder HELLP-Syndrom in der Anamnese

Preeclampsia or HELLP-SyndromeAntiphospholipid-Antibodies and other Thrombophilic Defects in Patients with a History of Early Onset Severe L. Heilmann, D. M. Schneider, G.-F. v. Tempelhoff, S. Kuse1
  • 1 Geburtsh., Stadtkrankenhaus Rüsselsheim
  • 2 Arbeitsgemeinschaft Gestose Frauen e.V.
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Publication History

Publication Date:
31 December 2000 (online)

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Zusammenfassung

Fragestellung: Wir untersuchten 61 Frauen mit schwerer Präeklampsie oder HELLP-Syndrom vor der 34. SSW mindestens 6 Monate postpartum auf angeborene oder erworbene Gerinnungsdefekte.Patienten und Methoden: Wir verglichen diese Gruppe mit 61 Frauen ohne Schwangerschaftskomplikationen.Ergebnisse: Wir fanden in 20 % eine Faktor V Leiden Mutation gegenüber 5 % in der Normalgruppe (OR 4,7, 95 % CI 1,4 - 15,8, p = 0,003). In 41 % konnten wir wiederholt Antikardiolipin-Antikörper nachweisen und in 3 % in der Kontrollgruppe (OR 20,5, 95 % CI 5,2 - 81,4, p = 0,001). In 54 % konnte eine Lupusantikoagulanz nachgewiesen werden gegenüber 3 % in der Kontrollgruppe (OR 34,8, 95 % CI 8,9 - 134,7, p < 0,001). Ein Protein C/S-Mangel trat in 10 % der Patientinnen mit Präeklampsie/HELLP auf, dagegen nur in 5 % in der Gruppe mit unkomplizierter Schwangerschaft (OR 2,1, 95 % CI 0,6 - 8,0, p = 0,25). In 16,4 % war eine chronische Hypertonie und in 20 % ein wiederholter Abort anamnestisch und klinisch nachzuweisen. In der Kontrollgruppe traten diese Ereignisse nicht auf.Schlußfolgerung: Bei Frauen mit schwerer Präeklampsie oder HELLP-Syndrom findet sich eine hohe Inzidenz für angeborene oder erworbene Gerinnungsdefekte.

Abstract

Objective: To evaluate the presence of thrombophilic defects in patients with a history of early-onset preeclampsia or HELLP syndrome. Methods: We compared the occurence of the factor V Leiden mutation, antiphospholipid antibodies, protein C/S and antithrombin deficiency in 61 women with a history of severe preeclampsia (n = 29) or HELLP syndrome (n = 32) and 61 normotensive women 6 months or longer after delivery.Results: Factor V Leiden mutation was found in 12 cases and 3 controls (20 % vs. 5 %, OR 4.7, 95 % CI 1.4 - 15.8, p = 0.003); IgG or IgM anticardiolipin antibodies in 25 cases and 2 controls (41 % vs. 3 %, OR 20.5, 95 % CI 5.2 - 81.4, p = 0.001); lupus anticoagulant in 33 cases and 2 controls (54 % vs. 3 %, OR 34.8, 95 % CI 8.9 - 134.7, p < 0.001); and protein C/S and antithrombin deficiency 6 cases and 3 controls (10 % vs. 5 %, OR 2.1, 95 % CI 0.6 - 8.0, p = 0.25). Twenty percent of the patients had a history of recurrent spontaneous abortion and 16 % had chronic hypertension.Conclusion: These data indicate a high incidence of inherited and acquired coagulation defects in women with a history of early-onset preeclampsia and HELLP syndrome.

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Prof. L. Heilmann

Abt. Gyn./Geburtsh. Stadtkrankenhaus

August-Bebel-Straße 59

D-65428 Rüsselsheim

Phone: 06142-88-1223

Email: 100.354323@germanynet.de