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Doggen, M. Heemskerk, F. Rosendaal, F. This may manifest itself as a reduced time to pregnancy increased fecundity and fewer miscarriages in the first trimester. All patients, unaware of their genotype, received a structured questionnaire.

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Factor V Leiden thrombophilia

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Rai, M. Backos, S. Elgaddal, A. Shlebak, L. Factor V Leiden is a common thrombophilic mutation. Control groups of women with a similar pregnancy history but who had a normal Factor V genotype were also studied. The live birth rate was Pregnancy is a hypercoagulable state Stirling et al. Since antiphospholipid antibodies aPL , an acquired thrombophilic defect, have been established as an important and treatable cause for pregnancy loss at all gestational ages Rai et al.

Factor V Leiden has also been reported in association with placental thrombosis Rai et al. Existing data on the association between Factor V Leiden and pregnancy outcome is weak in three important aspects. Firstly, the prevalence of Factor V Leiden amongst women with recurrent miscarriage has been variously reported to be either increased or similar to that amongst parous controls Balasch et al. This discrepancy may partly be explained by selection bias and the small numbers of women that have been included in some studies.

Secondly, whilst placental thrombosis in association with Factor V Leiden and other thrombophilic defects has been reported, this is neither a universal nor a specific finding Mousa and Alfirevic, and finally, there are no data on the prospective outcome of untreated pregnancies amongst women with Factor V Leiden and a history of pregnancy loss. Despite these limitations, some pregnant women with Factor V Leiden and a history of recurrent miscarriage have been subjected to heparin thromboprophylaxis, together with its attendant risks, in an attempt to improve their chance of a successful pregnancy Brenner et al.

The aim of this prospective observational study was to determine the pregnancy outcome of women with recurrent miscarriage who carry the Factor V Leiden allele and who receive no pharmacological treatment, except for folic acid, during pregnancy. This study was conducted between April and March All women had persistently negative tests for aPL, normal uterine anatomy and a normal peripheral blood karyotype, as did their partner.

No woman in this study had a personal history of systemic venous thrombosis. There was no significant difference in either the age or number of previous miscarriages between women with Factor V Leiden and their appropriate control group. Lupus anticoagulant LA was detected using the dilute Russell's viper venom time dRVVT together with a platelet neutralization procedure.

Anticardiolipin antibodies aCL were identified using a standardized enzyme-linked immunosorbent assay. Women with a positive test for LA or a positive aCL titre had a confirmatory test performed on a second sample taken at least 6 weeks after the initial sample. Women with persistently positive tests for either LA or aCL were considered to have the antiphospholipid syndrome and were treated with aspirin and heparin during pregnancy Rai et al.

The undigested PCR product measures base-pairs bp in size. Following cleavage with Mnl I, a normal allele produces bands of 37, 82 and bp. A mutant allele produces bands of 82 and bp due to loss of one Mnl I cleavage site.

Controls on each gel included a known heterozygote, a normal control known not to possess the Factor V Leiden allele and a water blank containing no input DNA. All women attended a dedicated early pregnancy clinic on a weekly basis from 5 weeks of amenorrhoea until 14 weeks gestation. At these visits, ultrasound scans were performed to confirm fetal viability and to assess fetal growth.

Survival data was analysed using the logrank test. Three woman in this cohort who carried the Factor V Leiden allele had a pregnancy loss after 12 weeks gestation, including one who had a severely growth-restricted stillborn infant delivered at 36 weeks gestation. In contrast, all miscarriages amongst those with a normal Factor V genotype occurred before 12 weeks gestation.

The survival plot of the outcome of each pregnancy in this cohort of women who presented with recurrent early miscarriage is shown in Figure 1. One woman in this cohort who carried the Factor V Leiden allele had a placental abruption at 28 weeks gestation and delivered a stillborn infant. No woman in this study had a symptomatic venous thrombosis during the antenatal, intra-partum or post-partum periods.

This is the first report of the prospective outcome of untreated pregnancies amongst a cohort of women with recurrent miscarriage who carry the Factor V Leiden allele.

The finding that these women are at significantly increased risk for miscarriage compared with those with a normal Factor V genotype highlights the importance of thrombophilic defects in the aetiology of adverse pregnancy outcome. However, it is equally important to note that some women who carry the Factor V Leiden allele have uncomplicated pregnancies and that maternal carriage of this thrombophilic mutation does not therefore preclude a successful, uncomplicated live birth at term.

The dual challenges raised by this study are i how to discriminate between those women with Factor V Leiden who are destined to miscarry or suffer a late pregnancy complication from those who will have a successful pregnancy and ii how should those women with Factor V Leiden identified as being at increased risk for future pregnancy loss be treated. Pregnancy complications associated with Factor V Leiden and other genetic thrombophilic mutations e.

However, the relative risk for the development of systemic thrombosis associated with these mutations is much lower heterozygous Factor V Leiden: 5-fold; heterozygous Factor II GA: 2-fold; homozygous MTHFR CT: 2-fold than that of previously identified haemostatic defects, such as heterozygous antithrombin deficiency 20—fold Cattaneo et al. There has consequently been a shift in emphasis from the restrictive concept of single, dominant causes of thrombosis to emphasizing the potential role of multiple, inherited risk factors.

This concept of the aetiology of systemic thrombosis is also likely to be applicable to placental thrombosis. Kupferminc et al. Clearly not all women who carry a thrombophilic mutation suffer a pregnancy loss and perhaps it is those who carry multiple thrombophilic defects who are at greatest risk. This is supported by the results of a retrospective study which reported that the odds ratio for stillbirth was significantly higher amongst women with combined thrombophilic defects The contribution of the fetal genotype in determining pregnancy outcome demands further investigation.

The placenta receives two arterial supplies one maternal and one fetal and placental infarction should only occur if both vascular supplies are compromised. The importance of this concept was illustrated in an earlier study which reported that placental infarction was significantly more often seen when the fetus carried the Factor V Leiden allele compared with when it had a normal Factor V genotype Dizon et al.

Two small studies, from the same group of investigators, have reported that heparin thromboprophylaxis during pregnancy leads to a high live birth rate amongst women with a history of adverse pregnancy outcome and a thrombophilic defect Brenner et al.

However, both studies were uncontrolled and the results must therefore be interpreted with caution. The results of our study suggest that attention should be directed at screening women with recurrent miscarriage associated with placental thrombosis for Factor V Leiden and a policy of targeted thromboprophylaxis during future pregnancies should be assessed in the form of a randomized controlled trial.

Survival plot of pregnancies amongst women with a previous recurrent early miscarriages. E-mail: r. Alhenc-Gelas, M. Balasch, J. Bertina, R. Nature , , 64 — Brenner, B. Cattaneo, M. Dahlback, B. Blood , 85 , — Dizon, T. Dizon-Townson, D. Grandone, E. Khamashta, M. Detection and importance of anticardiolipin antibodies. Kupferminc, M. Kutteh, W. Lane, D. Blood , 95 , — Metz, J. Mousa, H.

Preston, F. Lancet , , — Rai, R. Ridker, P. Souza, S. Stirling, Y. Svensson, P. Tal, J. Younis, J. Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account. Mills College. Sign In. Advanced Search. Search Menu. Article Navigation. Close mobile search navigation Article Navigation.

Volume Article Contents Abstract. Materials and methods. Factor V Leiden and recurrent miscarriage—prospective outcome of untreated pregnancies R. Oxford Academic. Google Scholar. Cite Cite R.

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A new study on the province level material footprint of China underscores the need to improve resource efficiency in the country, which would be crucial for moving to a circular economy. His attention to detail and computational skills were outstanding. This is very different to countries like the Netherlands where material impacts are driven by consuming things like food, electronic equipment, and services like insurance.

He was greatly influenced by his mother, who encouraged his literary aspirations. After troubles at school, he was taught at home and gained an exceptionally wide education. At the age of 16, Goethe began to study law at Leipzig University from to , and he also studied drawing with Adam Oeser. After a period of illness, he resumed his studies in Strasbourg from to Goethe practiced law in Frankfurt for two years and in Wetzlar for a year.

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Textbooks in the Netherlands contain significantly fewer female than male characters and relatively few characters from a non-Western background. They also contain implicit stereotyping. This is what Judi Mesman, Professor of the Interdisciplinary Study of Societal Challenges at Leiden University, has discovered in a study of all Dutch and mathematics textbooks used in the first year of secondary schools in the Netherlands. Judi Mesman and her team research what children learn about gender and ethnicity from the world around them. It gives you the idea that you too can do it. This influence is also called stereotype threat. It has already been shown that girls understand chemistry texts better if these are accompanied by pictures of female scholars. Publishers sent Mesman and her team copies of all the textbooks that are used in the first year of secondary school for the subjects of Dutch and mathematics. She discovered that women are systematically underrepresented in these books. Women were somewhat overrepresented among characters in a parental role and characters doing a domestic task.

Women and non-Western characters underrepresented in secondary school textbooks

A while ago I read an article in Delta by a Chinese girl who was writing about Dutch guys, for better or worse. Well, I thought, although they are a rare breed, what about women in Delft? Yes, even a blind man will quickly discover that Delft's a boys town and that the ratio of 6 or 7 guys for every chick is a sad but true fact of Delft life. And us foreign guys have got to be careful when entering places like the Aerospace Engineering Faculty: for that long blond-haired head that raises hopes when seen from behind will probably be, when it turns around, a dude with a beard! There may not be mountains in Holland, but for a South American man like me, the first thing you must overcome when arriving in Holland is your fear of heights!

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He was greatly influenced by his mother, who encouraged his literary aspirations. After troubles at school, he was taught at home and gained an exceptionally wide education. At the age of 16, Goethe began to study law at Leipzig University from to , and he also studied drawing with Adam Oeser.

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I'm looking for a room or an apartment in Leiden to stay in during that period, and roommates to share the Hi there! I am a 21 years old Law student from Paris.

If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care. You can find more tips in our guide, How to Find a Disease Specialist.

Tsinghua and Leiden researchers find that China is crucial for realising a circular economy

The municipality of Leiden had a population of , in August , but the city forms one densely connected agglomeration with its suburbs Oegstgeest , Leiderdorp , Voorschoten and Zoeterwoude with , inhabitants. The Netherlands Central Bureau of Statistics CBS further includes Katwijk in the agglomeration which makes the total population of the Leiden urban agglomeration ,, and in the larger Leiden urban area also Teylingen , Noordwijk , and Noordwijkerhout are included with in total , inhabitants. The recreational area of the Kaag Lakes Kagerplassen lies just to the northeast of Leiden. A university city since , Leiden has been one of Europe 's most prominent scientific centres for more than four centuries. Leiden is a typical university city, university buildings are scattered throughout the city and the many students from all over the world give the city a bustling, vivid and international atmosphere.

Nov 3, - TU Delft guys only need to visit a Leiden bar on a Saturday night to realize that they've I get nose-bleeds just looking up at Dutch women!

Rai, M. Backos, S. Elgaddal, A.

Before you turn to Google or free online dating sites for answers, check these 6 things to know about the Netherlands and dating! So here is our video on flirting in Dutch that will improve your love life here in no time. Windmills, tulips and cheese. The Netherlands is known for many things but what about the Dutch women and men?

Ничего не вижу, - пожаловалась.  - Включи свет. - Прочитаешь за дверью.

Остальные - все, что внизу.

Теперь же он был рад, что проделал это, потому что на мониторе Сьюзан скрывалось что-то очень важное. Задействованная ею программа была написана на языке программирования Лимбо, который не был его специальностью. Но ему хватило одного взгляда, чтобы понять: никакая это не диагностика. Хейл мог понять смысл лишь двух слов. Но этого было достаточно.

- Глаза ее смотрели сурово.  - Доктор. - Зюсс.  - Он пожал плечами. - Ладно, - нахмурилась Сьюзан.  - Попробуем еще… Кухня. - Спальня, - без колебаний отозвался .

Относительно его поездки. Я отправил Дэвида в Испанию. ГЛАВА 11 Испания. Я отправил Дэвида в Испанию.

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