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Recurrent Pregnancy loss

The Relationship between Factor V Leiden Mutation and Recurrent Abortion Among Palestinian Pregnant Women In The West Bank Ayman Hussein An-Najah National University. Recurrent Pregnancy loss Defined as 3 or more spontaneous fetal losses before the 20 th week of pregnancy .

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Recurrent Pregnancy loss

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  1. The Relationship between Factor V Leiden Mutation and Recurrent Abortion Among Palestinian Pregnant Women In The West Bank Ayman Hussein An-Najah National University

  2. Recurrent Pregnancy loss • Defined as 3 or more spontaneous fetal losses before the 20th week of pregnancy . • A major health problem affecting 0.5%-1.0% of pregnant women • occurring in about 20 % of all pregnancies, fewer than 50% of these cases have definitive causes .

  3. Thrombophilia • It is a predisposition to thrombosis. • It is a multigenic disorder caused by inherited and acquired factors • it contributes to the increasing incidence of poor pregnancy outcomes including recurrent abortion .

  4. Factor V • Factor V protein 330 k Da made chiefly by cells in the liver ,circulates in plasma as a single-chain molecule with a plasma half-life of about 12 hours1984). • In contrast to most other coagulation factors, it is not enzymatically active but functions as a cofactor

  5. Pregnant women have 2–5-fold higher risk for venous thromboembolism (VTE )compared to non-pregnant women. The FVL variant allele increasesthe risk for (VTE) during pregnancy 8–10times, compared to non-pregnant women with the wild-type genotype .

  6. Factor VProcoagulant and Anticoagulant Actions of Factor V. • Procoagulant : , factor Va enhances the activation of prothrombin (factor II) by factor Xa. • Anticoagulant :Factor V can serve (with protein S) as a cofactor in the inactivation of factor VIIIa by activated protein C (APC)

  7. خالد شلباية

  8. Factor V Leiden mutation • Inheritance is autosomal dominant. Heterozygous :4.5-14.5% Homozygous : 1:5000 • Present in 4 to 10% of people of Caucasian origin (Bertina et al 1994; Rees 1996). • The most common cause of inherited thrombophilia, accounting for 20% to 50% of cases (Bertina et al 1994). • Both homo. and heterozygous individuals with the mutation can develop thrombosis. Homo have 91 times increase in thrombosis .

  9. Objective The main objective of our study was : To investigate if there is a significant association between factor V Leiden mutation and Recurrent Abortion among Palestinian Pregnant Women In the West Bank.

  10. Methodology Case Control Study Design • Data collection : Uniformed questionnaire & direct contact . ( Specific Inclusion & exclusion criteria's ). • Research Place: the Medical Centres in West Bank • Ethical consideration: approved by the Research and Ethical Committee in An-Najah University and Alquds University. • Sample processing: 1-Blood sample collection ( Three medical centers ) 2-Genomic DNA Purification (Master Pure TMGenomic DNA Purification Kit) . 3-Genomic DNA Qualification (Agarose gel electrophoresis )

  11. Genomic DNA Qualification (Agarose gel .electrophoresis Figure 2.1 Agarose gel electrophoresis For Genomic DNA • Lanes 1-6 contain separate DNA samples (1 ul) • Lane 7 contains 100 Base Pair DNA Ladder as size marker. • **

  12. Identification of Mutation PCR & ARMS Test ARMS Test :One of the basic methods of DNA assays It is an accurate, rapid and simple method (amplification +diagnostic steps are combines). . *** The use of allele-specificprimers forPCR amplification RES

  13. Gel electrophoresis for Leiden mutation PCR product analysis 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Ula Abu Hilal.

  14. Results Obstetric History Case group: 191 women (at least 3 RA ). Control group: 205 women (gave normal birth for at least two babies). Data indicates that both groups show basically similar distribution according to Age , BMI values & usage of OCPs. The prevalence of Thromboembolic events among relatives of the case group (18.5 %) was higher than. that among relatives of the control group (2 %) ( P= (0.006

  15. Characteristics of study participants. Cases Controls No % No % Age (y) 32.0 - 31.9 - Marriage age (y) 19.3 - 18.8 - Regional Camp 115.0 60.0 141.0 69.0 City 47.0 24.7 40.0 19.4 Village 29.0 15.3 24.0 11.6 Smokers 19.0 10.0 19.0 10.0 Education level Low 153.0 79.5 166.0 81.3 High 38.0 20.5 39.0 18.7 BMI* Normal 55.0 29.2 61.0 30.0 Overweight 76.0 40.1 63.0 30.7 Obese 57.0 30.7 70.0 34.2 Abortion 78.0 43.0 0.0 0.0

  16. Leiden Mutation Prevalence among participants.

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