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Dziedziczna trombofilia i powtarzające się samoistne poronienia
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ISBN10: 6208879183
ISBN13: 9786208879181
Publisher: Wydawnictwo Nasza Wiedza
Published: Jul 17 2025
Pages: 68
Weight: 0.23
Height: 0.16 Width: 6.00 Depth: 9.00
Language: Polish
ISBN13: 9786208879181
Publisher: Wydawnictwo Nasza Wiedza
Published: Jul 17 2025
Pages: 68
Weight: 0.23
Height: 0.16 Width: 6.00 Depth: 9.00
Language: Polish
Trofoblasty lożyska wyrażają skladniki krzepnięcia niezbędne do rozwoju naczyń lożyska. Ich niedobór i rozwój patologii wewnątrzlożyskowej powodują niewydolnośc lożyska. Trombofilia zazwyczaj nie jest diagnozowana; większośc nosicieli nie wykazuje żadnych objawów. Powtarzające się samoistne poronienia (RSM) dotykają 2-5% par, a przyczyna tego zjawiska pozostaje nieznana w okolo 50% przypadków. Zakrzepica naczyń decidua utrudnia początkowy proces unaczynienia podczas implantacji. Nabyta trombofilia (przeciwciala antyfosfolipidowe, przeciwciala antykardiolipinowe i antykoagulant toczniowy) występuje częściej u kobiet w pierwszym trymestrze ciąży z zespolem antyfosfolipidowym. Dziedziczna trombofilia [mutacje genu czynnika V (FVL), protrombiny G20210A i reduktazy metylenotetrahydrofolianowej (MTHFR C677T)] jest czynnikiem ryzyka RSM. FVL identyfikuje opornośc na aktywowany proteinę C z nadkrzepliwością. Prothrombin G20210As jest związany z podwyższonym poziomem protrombiny. MTHFR C677T zmniejsza aktywnośc MTHFR, co powoduje zmniejszenie syntezy 5-metylotetrahydrofolianu, niezbędnego do przemiany homocysteiny w metioninę, zwiększając stężenie homocysteiny w osoczu. Niewyjaśnione RSM w pierwszym trymestrze ciąży może miec etiologię zakrzepową; badania histologiczne często wykazują obecnośc mikrotrombów lożyska w RSM.
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