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Trombofilia ereditaria e aborto spontaneo ripetuto
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ISBN10: 6208879175
ISBN13: 9786208879174
Publisher: Edizioni Sapienza
Published: Jul 17 2025
Pages: 68
Weight: 0.23
Height: 0.16 Width: 6.00 Depth: 9.00
Language: Italian
ISBN13: 9786208879174
Publisher: Edizioni Sapienza
Published: Jul 17 2025
Pages: 68
Weight: 0.23
Height: 0.16 Width: 6.00 Depth: 9.00
Language: Italian
I trofoblasti placentari esprimono componenti della coagulazione per lo sviluppo vascolare della placenta. Il fallimento di quest'ultimo e lo sviluppo di una patologia intra-placentare garantiscono l'insufficienza placentare. La trombofilia è solitamente non diagnosticata; la maggior parte dei portatori è asintomatica. L'aborto spontaneo ripetuto (RSM) colpisce il 2-5% delle coppie, con causa sconosciuta in circa il 50%. La trombosi dei vasi della decidua compromette il processo di vascolarizzazione iniziale al momento dell'impianto. La trombofilia acquisita (anticorpi antifosfolipidi, anticorpi anticardiolipina e lupus anticoagulant) è maggiore nelle donne del primo trimestre con sindrome antifosfolipidica. La trombofilia ereditaria [fattore V (FVL), protrombina G20210A e mutazioni del gene della metilenetetraidrofolato reduttasi (MTHFR C677T)] è un fattore di rischio per la RSM. La FVL identifica la resistenza alla proteina C attivata con stato di ipercoagulabilità . La protrombina G20210As è associata a una protrombina elevata. MTHFR C677T diminuisce l'attività di MTHFR con ridotta sintesi di 5-metiltetraidrofolato, necessario per la conversione dell'omocisteina in metionina, aumentando l'omocisteina plasmatica. La RSM inspiegabile del 1 trimestre può avere un'eziologia trombotica; gli studi istologici riportano comunemente microtrombi placentari nella RSM.
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