Thrombophilia-associated pregnancy wastage

Area of Science:

• Reproductive Medicine
• Hematology
• Genetics

Background:

• Recurrent fetal loss is often linked to antiphospholipid syndrome, an acquired autoimmune thrombophilic condition.
• Recent advancements have identified several heritable thrombophilic disorders, including factor V Leiden mutation and hyperhomocysteinemia, as significant contributors to thrombosis.
• Emerging data indicate a correlation between heritable thrombophilia and increased risks of fetal loss and preeclampsia.

Purpose of the Study:

• To critically evaluate the existing literature on inherited thrombophilia and its association with recurrent fetal loss.
• To explore potential pathophysiological mechanisms linking thrombophilia to pregnancy complications.
• To assess the efficacy of various therapeutic interventions for preventing fetal loss in affected women.

Main Methods:

• Comprehensive English-language literature review.
• Inclusion of studies focusing on women with repeated pregnancy wastage.
• Analysis of interventions such as aspirin, glucocorticoids, heparin, and IV immunoglobulin for miscarriage prevention.

Main Results:

• Heritable thrombophilia is associated with a higher risk of fetal loss and preeclampsia.
• Placental vascular pathologies are frequently observed in cases of recurrent fetal loss.
• Antiphospholipid syndrome is a recognized acquired autoimmune thrombophilic state linked to pregnancy loss.

Conclusions:

• Placental thrombosis may represent a common final pathway in habitual abortions and recurrent pregnancy wastage.
• Prophylactic antithrombotic therapy is indicated for women with heritable thrombophilia and antiphospholipid syndrome.
• Antithrombotic therapy may offer superior efficacy compared to traditional treatments like prednisone, aspirin, and IV immunoglobulin.