RISK FACTORS OF VENOUS THROMBOEMBOLISM IN SUDANESE PREGNANT WOMEN
Abdalhabib EK, Alfeel A, Ali EI, Ibrahim IK, Mobarki AA, Dobie G, Hamali HA, Saboor M,
*Corresponding Author: Dr. Muhammad Saboor, Department of Medical Laboratory Technology, Faculty of Applied Medical Science, Jazan University, Jazan, Saudi Arabia. Tel.: +966-54-495-9029. E-mail: msaboor@ jazanu.edu.sa
page: 49

RESULTS

Among the 396 study participants, 198 were pregnant women with VTE (VTE group) and the remaining 198 were healthy pregnant women (control group), with the mean (±SD) age being 28.21 ± 7.69 and 28.42 ± 5.93 years (p >0.05), respectively (data not shown in table). Among the VTE group, DVT was the most common clinical feature (n = 156, 78.8%), followed by pulmonary thromboembolism (n = 20, 10.1%). The frequencies of venous thrombosis of the upper limbs, portal vein, and cerebral vein were 5.1, 4.0 and 2.0%, respectively (Table 1). A total of 161 patients (81.3%) showed an association with various known risk factors of VTE, whereas 37 patients (18.6%) had no known risk factor of VTE (Table 2). Patients with a history of contraceptive use were more susceptible to developing VTE (33.8%). Moreover, high BMI (12.6%), termination (11.6%) and family history (10.1%), were the most common risk factors of VTE in the study population. The frequencies of other risk factors are shown in Table 2. Thrombophilia profiles revealed highly significant differences in the VTE group compared with those in the control group (p <0.05). The VTE group had significantly lower levels of PC (74.93 ± 40.8 vs. 97.83 ± 23.75 ng/mL) and PS (87.47 ± 25.24 vs. 102.46 ± 22.73 ng/mL) than those in the control group (p <0.01). Although, AT levels were slightly lower in the VTE group (80.19 ± 30.33 ng/ mL) than in the control group (85.46 ± 18.23 ng/mL), the differences were statistically significant (p <0.05) (Table 3). The frequency of PC deficiency was 6.7% in the VTE group compared with 1.01% in the control group. The frequency of PS deficiency in patients with VTE was also higher than that in the control group (Table 3). Moreover, AT deficiency was the most common abnormality among patients with VTE (11.6%) and controls (5.1%) (Table 3). Regarding FVL G1691A, the frequency of the homozygous normal genotype (G/G) was lower in the VTE group (96.0%) than in the control group (100.0%). Heterozygous (G/A) and homozygous (A/A) mutations were detected in the VTE group, with frequencies of 3.5% (n = 7) and 0.5% (n = 1), respectively (Table 4). The prothrombin G20210A mutation exhibited a statistically insignificant difference between the VTE and control groups (p = 0.499). Heterozygous (G/A) prothrombin G20210A mutation was found in only one patient (0.5%), and none of the study participants had the homozygous (A/A) mutation (Table 4). The FVL G1691A mutation was detected in 4.49% of patients (n = 7/156) with DVT and in 5.0% (n = 1/20) of those with pulmonary thromboembolism (Table 5). Patients with other conditions, such as venous thrombosis of the upper limb, cerebral vein thrombosis, and portal vein thrombosis did not exhibit the FVL G1691A mutation. Similarly, 11 (7.05%) patients with DVT had PC deficiency, one patient had pulmonary thromboembolism, and another patient had portal vein thrombosis. Furthermore, PS deficiency was found in 25.0% (n = 1/4) of patients with cerebral vein thrombosis and 10.26% (n = 16/156) of patients with DVT, as shown in Table 5. Details regarding AT deficiency in the observed cases are also presented in Table 5. Table 6 depicts the correlation of DVT, FVL G1691A polymorphism, and PC and PS deficiencies with risk factors, including age, family history, high BMI, contraceptive use and termination. In the study population, DVT was found to be correlated negatively with age (r = –0.122, p <0.05) but positively with contraceptive use, high BMI, and history of termination (p <0.05). Age, high BMI, and termination showed negative correlation with the FVL G1691A polymorphism, but these findings were statistically insignificant. Contraceptive use showed a statistically significant (p <0.05) positive correlation with the FVL G1691A polymorphism. Similarly, PC deficiency positively correlated (r = 0.227, p <0.05) with high BMI. The PS deficiency also showed a statistically significant (p <0.05) positive correlation with age and termination.



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