Intervention of Low-Molecular-Weight Heparin in M2/ANXA5 Haplotype Carriers: A Case Report in Pregnancy

Kai-Cheen Ang, Anna Liza Roslani, Nadja Bogdanova, Peter Wieacker, Arseni Markoff and Thean-Hock Tang

Universiti Sains, Malaysia
Department of Obstetrics and Gynecology, Kuantan Medical Centre, Malaysia
University of Muenster, Germany

^*Correspondance to: Anna Liza Roslani and Tang Thean Hock 

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Abstract:

Hereditary thrombophilia is viewed as a possible factor for repeated pregnancy loss (RPL), resulting in the onset of thrombotic events at the placenta that lead to adverse pregnancy outcome. The M2/ANXA5 haplotype is recognized as a third RPL susceptibility gene, RPRGL3, OMIM entry 614391, RPRGL1 is the factor V Leiden mutation (OMIM entry 614389), and RPRGL2 is the prothrombin mutation 20210G>A (OMIM entry 614390). An intervention with low molecular weight heparin (LMWH) could be a successful anticoagulant treatment for M2/ANXA5 carriers with RPL, rendering healthy pregnancy outcome. This is a case report of a heterozygous M2 carrier couple (both parents) with RPL history, who underwent the combination of aspirin and LMWH treatment and successfully delivered a live healthy singleton baby. Perinatal genotyping identified the newborn as M2 homozygote. Thus, in accordance with clinical trials addressing M2 carrier status, anticoagulation treatment might well be a remedy for recurrent miscarriage, supported with clinical evidence from this particular case. To address the general relevance of such treatment, a properly powered clinical trial will be instrumental that offers clear advantage if conducted with Malay RPL couples as target population.

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Cite the Article:

Ang K-C, Roslani AL, Bogdanova N, Wieacker P, Markoff A, Tang T-H. Intervention of Low-Molecular-Weight Heparin in M2/ANXA5 Haplotype Carriers: A Case Report in Pregnancy. Clin Case Rep Int. 2017; 1: 1006.