Coagulation Factor XII Congenital Deficiency in Women with Recurrent Miscarriage


Factor XII (Hageman factor) is an important protease that plays a major role in the initiation of the intrinsic pathway of blood coagulation and fibrinolysis and kinin formation. It is still unclear whether factor XII deficiency causes any disorders during pregnancy. Because the main clinical feature in patients with factor XII deficiency is thrombosis rather than bleeding, low dose aspirin would be expected to prevent first trimester miscarriage and a decrease in factor XII level itself was found to be an independent risk factor in recurrent miscarriage. The woman in a 31-year-old patient, with personal and family antecedents without interest and preceding obstetrics of two spontaneous abortions in the first quarter of the pregnancy without apparent cause. In the study of infertility practiced emphasizes a partition of not more than one centimetre of length in the uterine found by hysteroscopy exploration and in the study of hipercoagulability a light deficiency of the factor XII. Himself guideline processing with low dose of aspirin (125 mgr/day) and preconception folic acid (5 mgr/day), remains expectant mother and in the week 12 of her third pregnancy itself guideline antitrombotic prophylaxis with heparin of low molecular weight by subcutaneous way. The pregnancy reaches the week 39 without incidents of interest and the expectant mother give birth of spontaneous form to health boy. Repeated abortions may be associated with reduced level of factor XII activity of unknown origin and low-dose aspirin may prevent miscarriage caused for decreased factor XII levels in patients with a history of recurrent first trimester miscarriage.

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M. Mariano, P. Yadira, A. Ana, L. Manuel and L. Jesús, "Coagulation Factor XII Congenital Deficiency in Women with Recurrent Miscarriage," International Journal of Clinical Medicine, Vol. 2 No. 4, 2011, pp. 469-472. doi: 10.4236/ijcm.2011.24079.

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The authors declare no conflicts of interest.


[1] I. Braulke, M. Pruggmayer, P. Melloh, et al., “Factor XII (Hageman) Deficiency in Women with Habitual Abortion: New Subpopulation of Recurrent Aborters?” Fertility and Sterility, Vol. 59, No. 1, 1993, pp. 98-101.
[2] T. Matsuura, T. Kobayashi, T. Asahina, et al., “Is Factor XII Deficiency Related to Recurrent Miscarriage?” Semin Thromb Hemost, Vol. 27, 2001, pp. 115-120. doi:10.1055/s-2001-14069
[3] J. F. Schved, J. Ch. Gris, J. S. Neveu, et al., “Factor XII Congenital Deficiency and Early Spontaneous Abortion,” Fertility and Sterility, Vol. 52, No. 2, 1989, pp. 335-337.
[4] A. Sotiriadis, A. Makrigiannakis, T. Stefos, E. Para- skevaidis and S. N. Kalantaridou, “Fibrinolytic Defects and Recurrent Miscarriage: A Systematic Review and Meta-Analysis,” Obstetrics & Gynecology, Vol. 109, No. 5, 2007, pp. 1146-1155. doi:10.1097/01.AOG.0000260873.94196.d6
[5] D. W. Jones, M. J. Gallimore, M. Winter and M. More, “Pathogenic Antibodies to Coagulation Factors. Part II: Fibrinogen, Prothrombin, Thrombin, Factor V, Factor XI, Factor XII, Factor XIII, Protein C and Von Willebrand Factor,” Journal of Thrombosis and Haemostasis, Vol. 4, No. 1, 2006, pp. 282-284. doi:10.1111/j.1538-7836.2005.01712.x
[6] H. U. Pauer, P. Burfeind, H. Kostering, G. Emons and B. Hinney, “Factor XII Deficiency Is Strongly Associated with Primary Recurrent Abortions,” Fertility and Sterility, Vol. 80, No. 3, 2003, pp. 590-594. doi:10.1016/S0015-0282(03)00788-X
[7] J. C. Gris, S. Ripart-Neveu, C. Maugard, et al., “Respective Evaluation of the Prevalence of Haemostasis Abnormalities in Unexplained Primary Early Recurrent Miscarriages, The Nimes Obstetricians and Haematologists (NOHA) Study,” Thrombosis and Haemostasis, Vol. 77, No. 6, 1997, pp. 1096-1103.
[8] M. S. Ogasawara, K. Aoki, K. Katano, et al., “Factor XII but Not Protein C, Protein S, Antithrombin III, or Factor XIII Is a Predictor of Recurrent Miscarriage,” Fertility and Sterility, Vol. 75, No. 5, 2001, pp. 916-919. doi:10.1016/S0015-0282(01)01688-0
[9] A. Inomo, T. Sugi, Y. Fujita, et al., “The Antigenic Binding Sites of Autoantibodies to Factor XII in Patients with Recurrent Pregnancy Losses,” Thrombosis and Haemostasis, Vol. 99, No. 2, 2008, pp. 316-323.
[10] D. W. Jones, M. J. Gallimore and M. Winter, “Recurrent Abortion-Antibodies to Factor XII or a Decrease in Factor XII Levels?” Fertility and Sterility, Vol. 76, No. 6, 2001, pp. 1288-1289. doi:10.1016/S0015-0282(01)02917-X
[11] M. S. Ogasawara, Y. Iinuma, K. Aoki, et al., “Low-Dose Aspirin is Effective for Treatment of Recurrent Miscarriage in Patients with Decreased Coagulation Factor XII,” Fertility and Sterility, Vol. 76, No. 1, 2001, pp. 203-204. doi:10.1016/S0015-0282(01)01819-2
[12] T. Sugi and T. Makino, “Antiphospholipid Antibodies and Kininogens in Pathologic Pregnancies: A Review,” American Journal of Reproductive Immunology, Vol. 47, No. 5, 2002, pp. 283-288.
[13] D. W. Jones, I. J. MacKie, M. J. Gallimore and M. Winter, “Antibodies to Factor XII and Recurrent Fetal Loss in Patients with the Anti-phospholipid Syndrome,” British Journal of Haematology, Vol. 113, No. 2, 2001, pp. 550- 552. doi:10.1046/j.1365-2141.2001.02776.x
[14] D. W. Jones, M. J. Gallimore and M. Winter, “Antibodies to Factor XII: A Possible Predictive Marker for Recurrent Foetal Loss,” Immunobiology, Vol. 207, No. 1, 2003, pp. 43-46.
[15] S. Daya, “Issues in the Etiology of Recurrent Spontaneous Abortion,” Current Opinion in Obstetrics & Gynecology, Vol. 6, No. 2, 1994, pp. 153-159. doi:10.1097/00001703-199404000-00008
[16] K. Fiedler and W. Wurfel, “Effectivity of Heparin in Assisted Reproduction,” European Journal of Medical Research, Vol. 9, No. 4, 2004, pp. 207-214.

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