FIBRINOLYTIC PATTERN IN RECURRENT SPONTANEOUS-ABORTIONS - NO RELATIONSHIP BETWEEN HYPOFIBRINOLYSIS AND ANTIPHOSPHOLIPID ANTIBODIES

Patients with antiphospholipid antibodies may suffer from thrombotic e vents and recurrent spontaneous abortions. A defective fibrinolytic po tential has been described in women with recurrent fetal losses. We in vestigated the prevalence of anticardiolipin antibodies and of various fibrinolytic abnormalities in 64 females with a history of at least t wo abortions of unknown origin, Anticardiolipin antibodies were presen t in the serum of 31 patients (48.4%). The overall prevalence of fibri nolytic disorders was 67.2% (43 cases) and resulted significantly high er than that of aCL positivity (P = 0.03), In most of cases the impair ed fibrinolytic potential after venous occlusion test was due to incre ased PAI-1 levels; only in a few instances a defective fibrinolytic re sponse was due to reduced t-PA release, a combined defect or an intrin sic fibrinolytic deficiency. After division of patients in two groups on the basis of the aCL presence, the distribution of different fibrin olytic defects was similar in aCL positive and negative women, suggest ing the lack of correlation between hypofibrinolysis and aCL antibodie s. Plasminogen abnormalities resulted compatible with congenital hypop lasminogenemia in two aCL negative women, whereas in four aCL positive patients they were suggestive for acquired dysplasminogenemia. Our re sults indicate that patents with recurrent spontaneous abortions mat p resent fibrinolytic disorders, which occur independently and more ofte n than aCL positivity, An accurate investigation of the fibrinolytic p otential, and, namely, of PAI-1 levels, should be included in the stud y of females suffering from repeated fetal losses. (C) 1994 Wiley-Liss , Inc.