Antiphospholipid-antibodies and other thrombophilic defects in patients with a history of early onset severe preeclampsia or HELLP-syndrome

Objective: To evaluate the presence of thrombophilic defects in patients wi th a history of early-onset preeclampsia or HELLP syndrome. Methods: We compared the occurence of the factor V Leiden mutation, antipho spholipid antibodies, protein CIS and antithrombin deficiency in 61 women w ith a history of severe preeclampsia (n=29) or HELLP syndrome (n=32) and 61 normotensive women 6 months or longer after delivery. Results: Factor V Leiden mutation was found in 12 cases and 3 controls (20% vs. 5%, OR 4.7, 95% CI 1.4-15.8, p=0.003); IgG or IgM anticardiolipin anti bodies in 25 cases and 2 controls (41 % vs. 3 %, OR 20.5, 95 % CI 5.2 - 81. 4, p = 0.001); lupus anticoagulant in 33 cases and 2 controls (54 % vs. 3 % , OR 34.8, 95 % CI 8.9-134.7, p < 0.001); and protein YS and antithrombin d eficiency 6 cases and 3 controls (10% vs. 5 %, OR 2.1, 95 % Cl 0.6-8.0, p=0 .25). Twenty percent of the patients had a history of recurrent spontaneous abortion and 16% had chronic hypertension. Conclusion: These data indicate a high incidence of inherited and acquired coagulation defects in women with a history of early-onset preeclampsia and HELLP syndrome.