Page 46 - Pro-active Management of Women’s Health after Cardiometabolic Complicated Pregnancies

44 | Part 2 Cardiovascular Health MATERIAL AND METHODS
From 1985 until 2010 all patients with a singleton pregnancy who were admitted for mild or severe preeclampsia to the department of obstetrics of the Erasmus University Medical Center, University Medical Centre Rotterdam, were offered to be postpartum screened for thrombophilia factors. Preeclampsia was diagnosed according to the definition of the International Society for the Study of Hypertension (ISSHP). Severe preeclampsia was diagnosed if one or more of the following criteria were present: a blood pressure of 160 mmHg systolic or higher or 110 mmHg diastolic or higher proteinuria of 5 gram or more in a 24- hour urine specimen or dipstick urinalysis of 3+ or greater in two random urine samples collected at least 4 hours apart; cerebral or visual disturbances; elevated liver enzymes; thrombocytopenia; fetal growth restriction. HELLP was defined as a combination of platelet count <100x109/L, serum aspartate aminotransferase (ASAT) ≥30 U/L and serum alanine aminotransferase (ALAT) ≥30 U/L (2 SD above the mean in our hospital). Intrauterine growth restriction (IUGR) was defined as a birth weight below the 10th centile.
At least six weeks postpartum, patients were tested for: anti-cardiolipin antibodies, lupus anticoagulans, APC-ratio, levels of protein C and S, homocysteine and heterozygosity for factor V Leiden and Prothrombin gene mutation. None of the patients were using vitamin supplements during the period of testing.
The reference values for the coagulation assays were ascertained in a population of at least 40 normal male volunteers. Anti-cardiolipin antibodies were determined by enzyme-linked immunoassay (ELISA) according to the directives of Harris (normal values IgG and IgM <31 units GPL and <12 units MPL respectively). The presence of lupus anticoagulant was determined with the