PP045. Different associations between phenotypes of preeclampsia and thrombophilias.

INTRODUCTION

Studies on the association of preeclampsia (PE) with thrombophilias (TRPH) are conflicting. Clinical heterogeneity of PE may be one of the explanations.

OBJECTIVES

The present study addresses the question whether different phenotypes of PE are associated with subtypes of TRPH.

METHODS

In this retrospective cohort study between 1985 until 2010 women with PE were offered postpartum screening for the following TRPH: anti-phospholipid antibodies (APA), APC-resistance, protein C deficiency and protein S deficiency (PSD), hyperhomocysteinemia (HCY), factor V Leiden and Prothrombin gene mutation.

RESULTS

890 Women with PE were screened for TRPH. 49% Also had HELLP, 60% had IUGR, 71% delivered before the 34th week. One or more TRPH factors were present in 31% of the women. Severe PE was associated with PSD (p=0.01). IUGR (p<0.01) was associated with APA (p<0.01) and PSD (P=0.03). Early onset PE was associated with APA (P, 0.01). More than 10% of placental infarction was associated with APA (p<0.01). Placental weight below the 5th percentile was associated with HCY (p=0.03). Other phenotypes of PE and TRPH were not associated.

CONCLUSION

Severe and early onset PE, especially if complicated by IUGR, are associated with APA and PSD. Other phenotypes of PE, especially HELLP syndrome, were not associated with TRPH. We advise to screen for APA and PSD after severe and early onset PE, especially if complicated by IUGR. We do not recommend screening for TRPH in other phenotypes of PE.