The role of factor V Leiden and prothrombin G20210A mutations for clotting in Sudanese women under oral contraceptive use

Background & objectives: The risk of venous thromboembolism (VTE) in women using combination oral contraceptives (COC) is attributed to changes in hemostasis. These changes are greatly affected in women with a hereditary thrombotic predisposition. The present study investigated the relationship between genetic mutations associated with deep venous thrombosis and oral contraceptive use in pregnant women. Materials and methods: This was a case-control study to detect factor V Leiden (FVL) and prothrombin G20210A mutations in Sudanese pregnant women. Three hundred individuals were included in this study (200-study group; 100- control group). Both these groups were diagnosed as having deep vein thrombosis (DVT). Genetic mutations were determined using RT-PCR. Proteins C, protein S, antithrombin III (ATIII), fibrinogen, prothrombin time (PT), international normalize ratio (INR), thrombin time (TT) and activated partial thromboplastin time (APTT) were measured. Results: The results of genetic analysis for factor V Leiden mutation showed that two patients had the mutant allele (A A), twenty-two had mixed type (GA), and the remaining one hundred seventy-six had wild type (G G). The entire control group had only one the mixed type (GA), remaining had wild type (G G). Regarding prothrombin, G20210A mutation showed only the wild type (G G) in both the study group and the control group. Protein C, protein S and plasma fibrinogen was significantly lower in the study group compared to the control group. No statistically significant difference was observed in ATIII, PT, TT and APTT between the study group and the control group. Interpretation & conclusion: The oral contraceptives were associated with increased risk of developing deep vein thrombosis (DVT) among Sudanese pregnant women. The prevalence of factor V Leiden mutations was more than prothrombin mutations among pregnant women.