Recurrent Placental Abruption with Methylenetetrahydrofolate Reductase C667t Heterozygosity: A Case Report

Abstract

Placental abruption although uncommon, can result in high rate of maternal and fetal morbidity and mortality. Several studies suggest abnormal placental vasculature, thrombosis and reduced placental perfusion in pathophysiology. Genetic variations may predispose to these problems.
Case: A thirty year old 28 weeks pregnant women underwent cesarean section with the diagnosis of placental abruption, intrauterine dead fetus and previous cesarean section in our clinic. It was learned that she had a cesarean section due to placental abruption 1 year ago. In the postoperative period trombophilia markers, methylenetetrahydrofolate reductase , Factor V leiden and Prothrombin gene polymorphism, homocystein, folate and vitamin B12 levels and genetic karyotyping were evaluated. The only pathology was the metylenetetrahydrofolate reductase gene heterozygosity for the C to T substitution at nucleotide 677.
Risk of recurrence is high in patients with a history of placental abruption. Antenatal care and delivery after fetal lung maturation is advised since the perinatal mortality is high with placental abruption.