This study was conducted to investigate the association of maternal and/or fetal factor V Leiden (FVL) and G20210A prothrombin mutation with HELLP syndrome. FVL and G20210A prothrombin mutation were determined using PCR. Sixty-three pregnant women, 36 of them diagnosed with HELLP syndrome, were included in the study. Overall, 68 children were born as a result of these pregnancies and blood sampling was possible in 28 out of 39 children from HELLP patients and 25 out of 29 children from the control women. The prevalence of a maternal FVL was elevated 2-fold in HELLP patients compared with the control women [six out of 36 (16.7%) compared with two out of 27 (7.4%); P=0.282]. None of the HELLP patients and only one woman in the control group was found to be positive for the G20210A prothrombin mutation (P=0.251). The fetal carrier frequency was four out of 28 compared with three out of 25 for FVL (P=0.811), and two out of 28 compared with one out of 25 for G20210A prothrombin mutation (P=0.629). Intrauterine growth restriction (IUGR) was significantly higher in fetuses found to be positive for a thrombophilic mutation (P=0.022). IUGR occurred in seven out of ten fetuses with a thrombophilic mutation compared with 11 out of 43 in fetuses without a mutation. The prevalence of FVL, but not of the G20210A prothrombin mutation, seems to be elevated in women with HELLP syndrome. A fetal thrombophilic mutation does not contribute significantly to the clinical features of the HELLP syndrome. Our results demonstrate a fetal contribution to IUGR. Fetal thrombophilic mutations may lead to placental microthrombosis, which consecutively could lead to a disturbed fetoplacental blood flow and thus cause growth restriction.
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Research Article|
September 01 2003
Association of maternal and/or fetal factor V Leiden and G20210A prothrombin mutation with HELLP syndrome and intrauterine growth restriction
Dietmar SCHLEMBACH;
*Department of Obstetrics and Gynaecology, University of Erlangen-Nuremberg, Universitaetsstrasse 21-23, 91054 Erlangen, Germany
Correspondence: Dr Dietmar Schlembach, present address: Department of Obstetrics and Gynaecology, University of Texas Medical Branch, Medical Research Building, 301 University Boulevard, Galveston, TX 77555-1062, U.S.A. (e-mail [email protected]).
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Ernst BEINDER;
Ernst BEINDER
*Department of Obstetrics and Gynaecology, University of Erlangen-Nuremberg, Universitaetsstrasse 21-23, 91054 Erlangen, Germany
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Juergen ZINGSEM;
Juergen ZINGSEM
†Department of Transfusion Medicine and Haemostaseology, University of Erlangen-Nuremberg, Krankenhausstrasse 12, 91054 Erlangen, Germany
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Ute WUNSIEDLER;
Ute WUNSIEDLER
‡Department of Paediatrics, University of Erlangen-Nuremberg, Loschgestrasse 1, 91054, Erlangen, Germany
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Matthias W. BECKMANN;
Matthias W. BECKMANN
*Department of Obstetrics and Gynaecology, University of Erlangen-Nuremberg, Universitaetsstrasse 21-23, 91054 Erlangen, Germany
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Thorsten FISCHER
Thorsten FISCHER
*Department of Obstetrics and Gynaecology, University of Erlangen-Nuremberg, Universitaetsstrasse 21-23, 91054 Erlangen, Germany
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Publisher: Portland Press Ltd
Received:
February 20 2003
Revision Received:
April 16 2003
Accepted:
May 02 2003
Accepted Manuscript online:
May 02 2003
Online ISSN: 1470-8736
Print ISSN: 0143-5221
© 2003 The Biochemical Society
2003
Clin Sci (Lond) (2003) 105 (3): 279–285.
Article history
Received:
February 20 2003
Revision Received:
April 16 2003
Accepted:
May 02 2003
Accepted Manuscript online:
May 02 2003
Citation
Dietmar SCHLEMBACH, Ernst BEINDER, Juergen ZINGSEM, Ute WUNSIEDLER, Matthias W. BECKMANN, Thorsten FISCHER; Association of maternal and/or fetal factor V Leiden and G20210A prothrombin mutation with HELLP syndrome and intrauterine growth restriction. Clin Sci (Lond) 1 September 2003; 105 (3): 279–285. doi: https://doi.org/10.1042/CS20030073
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