Platelet Indices and Antiphospholipid Syndrome in Patients with Recurrent Pregnancy Loss

Introduction: Spontaneous pregnancy loss is a common occurrence. Recurrent pregnancy loss (RPL) is defined as two or more failed clinical pregnancies as documented by ultrasonography or histopathologic examination before 20 weeks gestation. Ectopic, molar, and biochemical pregnancies are not included.

Aim: To examine the relationship between platelet indices and the presence of antiphospholipid syndrome (APS) in RPL patients.

Methodology: This study was conducted on fifty first-trimester pregnant females with a history of RPL. Control group included fifty first-trimester pregnant females without history of RPL with at least one live birth. Lupus anticoagulant (LA) testing with simplified dilute Russell’s Viper venom test (DRVVT) and anti-cardiolipin (aCL) antibodies detection with Human Anti-Cardiolipin IgG/IgM ELISA. CBC for mean platelet volume (MPV), Platelet distribution width (PDW), and plateletcrit (PCT) was done for all patients.

Results: The age and the gravida number of the patients were significantly higher than of the control. All platelet indices were significantly higher among RPL group compared to control. According to the positivity of LA and aCL antibodies, RPL patients were classified into 2 groups, 25 patients each, positive and negative for APS respectively. Comparing platelet indices between both subgroups, PCT and MPV were significantly higher among APS positive patients, while PDW did not attain any significance. Receiver operating characteristic (ROC) curve analysis was applied to assess the best cut off value for predicting RPL in patients with APS who may benefit from early treatment.

Conclusion: These low-cost and easily measurable indices can be used for prediction of fetal loss and may help clinicians start early management of high-risk RPL cases.