Platelet reactivity and pregnancy loss

• Published in: American journal of obstetrics and gynecology 2010-09, Vol.203 (3), p.281.e1-281.e5
• Main Authors: Flood, Karen, MD, Peace, Aaron, PhD, Kent, Etaoin, MD, Tedesco, Tony, MD, Dicker, Patrick, PhD, Geary, Michael, MD, Malone, Fergal D., MD, Kenny, Dermot, MD
• Format: Article
• Language: English
• Subjects: Abortion, Habitual - blood; Adenosine Diphosphate - pharmacology; Adult; arachidonic acid; Arachidonic Acid - pharmacology; Biological and medical sciences; Case-Control Studies; Collagen Type I - pharmacology; Diseases of mother, fetus and pregnancy; Dose-Response Relationship, Drug; Epinephrine - pharmacology; Female; Gynecology. Andrology. Obstetrics; Humans; Medical sciences; Middle Aged; Obstetrics and Gynecology; Peptide Fragments - pharmacology; Platelet Aggregation - drug effects; Platelet Function Tests; platelet reactivity; Pregnancy; Pregnancy Trimester, First; Pregnancy. Fetus. Placenta; Prospective Studies; recurrent miscarriage
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2010.06.023

Objective We sought to critically evaluate platelet function in recurrent miscarriage (RM). Study Design We conducted a prospective study comparing 30 patients with unexplained recurrent first-trimester pregnancy loss with 30 control subjects matched for age and serum progesterone level. Platelet function was determined using a modified assay of light transmission aggregometry with multiple agonists at different concentrations. Dose-response curves were created and half-maximal effective concentration values were calculated. Results At test completion the half-maximal effective concentration values for arachidonic acid in the patients with RM were significantly less than in the control subjects (0.153 vs 0.230; P = .0099). The dose-response curves were tightly matched for the other agonists. Conclusion This novel measurement of platelet function has demonstrated that patients with unexplained RM have significantly increased platelet aggregation in response to arachidonic acid. The enhanced response to this agonist provides an empirical rationale for the use of aspirin in management of this clinical condition.