S96 Abstracts / Thrombosis Research 131, Suppl. 1 (2013) S71–S103 P-074 Antiphospholipid antibodies: Incidence and implications in women with immune thrombocytopenic purpura I. Djunic 1 , J. Jovanovi 5 , N. Suvajdzic-Vukovic 1,2 , B. Bonaci-Nikolic 2,3 , A. Novkovic 4 , A. Vidovic 1,2 , D. Tomin 1,2 1 Clinic for Hematology, Clinical Center of Serbia, Belgrade; 2 Medicine Faculty University of Belgrade, Serbia; 3 Clinic for Alergology and Immunology, Clinical Center of Serbia; 4 Clinical Hospital Center “Zemun”, Belgrade, Serbia; 5 General Hospital, Department for Internal diseases, Krusevac, Serbia Objective: To assess the incidence of antiphospholipid andibodies (APA) and their impact on the development of antiphospholipide syndrome (APS) and systemic autoimmune diseases (SAID) in women with immune thrombocytopenic purpura (ITP). Methods: Fifty-five adult female patients with ITP were assessed. At diag- nosis they were evaluated for antinuclear antibodies (ANA) and APA: lupus anticoalgulant (LA); anticardiolipin antibodies (ACA). The follow-up period was 96 months. Results: The median age of patients was 37 years, range 18–54 years. At ITP diagnosis APA were detected in 56% of patients: ACA and LA in 28%, ACA alone in 36% while LA alone in 56% of patients. Positive ANA were registered in 28% of patients. APS was diagnosed in 13% (7) of patients before onset of ITP. During the follow-up period, APS detected in 8% (4) and SAID in 16% (9) of patients. Multivariate analysis proved that the most significant risk factor for the development of APS was prior LA positivity: p=0.022, relative risk (RR)=1.800 (95% CI 0.0603–5.371) while the most significant risk factor for the development of SAID was coexistent ACA and LA positivity: p=0.027, RR=2.00 (95% CI 0.500–7.997). Conclusions: The most significant risk factor for the development of APS in female patients affected with ITP was LA positivity. Herein the most significant risk factor for development of SAID in female with ITP was mutual positivity of ACA and LA. In conclusion, the assessment APA at diagnosis of ITP is important for identification of patients at risk for the development of APS and SAID. P-075 Prevalence of severe dysmenorrhea among women with consecutive first-trimester miscarriages S. Hoirisch-Clapauch High-Risk Maternal and Fetal Unit, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil Background: Plasmin is required to activate metalloprotaineses involved in placental angiogenesis. We postulate that inadequate fibrinolysis prevents big clots to be dissolved, causing severe dysmenorrhea. In this case, severe dysmenorrhea could predict early fetal losses. Nulliparae usually report more pain because adrenergic innervations of the isthmic myometrium disappear during pregnancy, regenerating only partially thereafter. Ad- ditionally, the uterine cervix is stretched after delivery, facilitating the expulsion of clots. Oral contraceptives reduce the pain, probably because estrogen increases the synthesis of plasminogen activators and proges- terone competes with PRMC1/PAIRBP, the uterine receptor of PAI-1. Methods: The history of severe dysmenorrhea before the first pregnancy and not taking hormonal contraceptives was assessed in 165 women at a High-Risk Maternal and Fetal Unit. Patients comprised 82 women with consecutive first-trimester miscarriages (2–9, mean = 3.6) and ≥1 normal abortus karyotype and 83 controls with ≥2 pregnancies and no losses or preterm deliveries. Three patients with endometriosis, pelvic inflammatory disease or uterine abnormalities were excluded from each group. Severe dysmenorrhea was defined as sharp menstrual cramp, centered in the suprapubic area, intense enough to cause significant disruption in quality of life or absenteeism if women were not medicated. Results: Severe dysmenorrhea was reported by 53 (67%) women with mis- carriages and 19 (24%) controls, conferring an odds ratio for recurrent early miscarriages of 7 (95% CI, 3.4–14.1; p<0.001). After excluding patients with antiphospholipid syndrome, factor V Leiden, factor II G20.210A, deficiency of antithrombin III, protein C or free-protein S, odds ratio was 6 (95% CI, 2.8–13; p<0.001). Conclusion: Our results suggest that abnormal fibrinolysis could play a role in recurrent early miscarriages. P-076 Early neonatal hypoglycemia prediction according to maternal parameters S. Hoirisch-Clapauch 1 , M.A.S. Porto 2 1 High-Risk Maternal and Fetal Unit; 2 High-Risk Neonatal Unit, Hospital Federal dos Servidores do Estado, Rio de Janeiro, RJ, Brazil Objective: To determine whether maternal parameters could predict early neonatal hypoglycemia. Methods: Glycemic levels of 106 neonates born to a cohort of nor- moglycemic mothers with indicators suggestive of abnormal insulin metabolism near delivery and of 67 neonates born to diabetic mothers were analyzed. Results were correlated to maternal indicators, such as: excessive carbohydrate intake; maximum rest; invasive bacterial infec- tions; corticosteroid intake; delivery of a large-for-gestational-age infant; acanthosis nigricans; and grade III obesity. Results: Independent risk factors for early neonatal hypoglycemia in both populations were: excessive carbohydrate intake the day before delivery – including ≥50 g intravenous/oral glucose to correct iatrogenic hypo- glycemia odds ratio [OR] = 11 (95% Confidence Interval [95% CI]: 4–24, P<0.001), and maximum rest ≥2 days before delivery OR = 5 (95% CI: 2–11 P<0.001). A balanced diet plus ≥12-hour fast before delivery decreased the risk, OR = 0.2 (95% CI: 0.08–0.4, P<0.001). Excessive carbohydrate intake plus maximum rest conferred an OR = 329 (95% CI: 32–3362, P<0.001) compared to no risk factors. Excessive carbohydrate intake throughout pregnancy stimulates fetal beta cells to synthesize an excess of insulin, resulting in macrosomia. Excessive carbohydrate intake combined to lack of physical activity stimulates mater- nal beta cells to synthesize insulin. Abnormal response results in gestational diabetes. Adequate response (hyperinsulinemia) stimulates plasminogen activator inhibitor 1 synthesis. Resultant hypofibrinolysis impairs placen- tal remodeling and intrauterine growth restriction “corrects” macrosomia. In this setting, prematurity and small-for-gestational-age infants are a consequence of maternal risk factors that increase the risk for neonatal hyperinsulinemia and hypoglycemia. Conclusions: Excessive carbohydrate intake and maximum rest near de- livery are independent predictors for early neonatal hypoglycemia, even in appropriate-for-gestational-age term neonates born to normoglycemic mothers. (This study was supported by funds from State of Rio de Janeiro Financing Agency for Research, FAPERJ E-26/190.050/2011). P-077 Clinical value of determination of APC-resistance and protein C global test in obstetric practice I.A. Mikhailidi, I.K. Santrosyan Department of Obstetrics and Gynecology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia Background: APC-resistance and protein C global test are global tests and the methods, allowing to define factor V Leiden mutation, circulation of