Anti-Phospholipid Syndrome among Aborted Women in Their Second-Trimester in Gaza: Case-Control Study

Mahmoud S. El-Haj Ahmed
محمد الحاج أحمد
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Al-Quds University
Background: Antiphospholipid syndrome (APS) is an acquired thrombophilia cause recurrent venous or arterial thrombosis and/or fetal loss, which occurs in approximately (1%) of women worldwide. Aim: to assess the relationship between APS and second-trimester abortion in Southern Gaza Governorates. Methods: The design of the study is a case-control study. Convenient sample obtained from Southern Gaza Governorates, one hundred participants of equal number of cases and control. Data collected by two methods: The first, a questionnaire interview which included socioeconomic data and group of risk factors to exclude them from the study. The second, which included withdrawal blood samples to investigate group of tests related to APS and abortion. For this study we used techniques such as ELISA, Ag-Ab reaction and spectrophotometer to measure the level of various variables such as lupus anticoagulant (LA) test, dilute Russell viper venom time (dRVVT), anticardiolipin (ACL) (IgM and IgG), toxoplasma (IgM), rubella (IgM), fasting blood sugar (FBS) and thyroid stimulating hormone (TSH). Results: The results of our study showed that there is a statistically significant relationship between APS and second-trimester abortion (P < 0.05). Also we found significant relationship between dRVVT and second-trimester abortion. As well LA test showed a significant relationship with the second-trimester abortion (P < 0.05). Moreover, the dRVVT was the most specific test for APS diagnosis. According to our results morbidity and mortality associated with APS second-trimester abortion could be decreased by early diagnosis of APS using dRVVT as a diagnostic test beside clinical findings. There is no relationship between toxoplasma (IgM) and second-trimester abortion. Moreover, there is no relationship between rubella (IgM) and second-trimester abortion. Conclusion: Our findings added an impute in the early diagnosis of APS and dRVVT is the most specific test for APS diagnosis more than other tests. Also the tests that were positive for APLs should be repeated after 6 weeks because actual cases usually have persistent APLs in their blood. In future research there is a need to study inherited thrombophilia and its relationship to abortion.