Activated partial thromboplastin time is a predictive parameter for further miscarriages in cases of recurrent fetal loss

Objective: To determine whether clinically routine clotting tests such as a ctivated partial thromboplastin time (aPTT), prothrombin time (PT), or fibr inogen can be used to predict further miscarriages. Design: Prospective study. Setting: Nagoya City University Hospital, Nagoya, Japan. Patient(s): A total of 261 patients with a history of two consecutive first -trimester spontaneous abortions who had no antiphospholipid antibodies or other autoimmune diseases and no anatomic anomalies were examined for aPTT, PT, and fibrinogen before becoming pregnant again. Intervention(s): Blood tests were performed before pregnancy. Patients then were followed up during subsequent pregnancy and their outcomes were compa red with their previous bleed test results. Main Outcome Measure(s): Activated partial thromboplastin time, PT, and fib rinogen were measured by coagulation time methods. Result(s): Fifty-eight of 261 patients (22.2%) had a subsequent miscarriage . Mean (+/-SD) values for preconception aPTT in individuals whose subsequen t pregnancies ended in success and failure were 88.2% +/- 23.4% and 99.3% /- 26.4%, respectively. The difference was statistically significant. Respe ctive values were 106.8% +/- 22.8% and 106.3% +/- 21.4% for PT and 245 +/- 61.1 mg/dL and 259.1 +/- 57 mg/dL for fibrinogen. These findings were not s ignificantly different. Conclusion(s): A shortened aPTT before conception is associated with furthe r miscarriages in patients with a history of recurrent spontaneous abortion s who have no antiphospholipid antibodies. (Fertil Steril(R) 1998; 70: 1081 -4. (C) 1998 by American Society fbr Reproductive Medicine.)