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Heritable coagulopathies in pregnancy.

C J Lockwood1

  • 1Department of Obstetrics and Gynecology, New York University School of Medicine, NY 10016, USA.

Obstetrical & Gynecological Survey
|December 22, 1999
PubMed
Summary
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Heritable coagulopathies significantly increase maternal risks for thromboembolism, stillbirth, and other complications during pregnancy. Effective management, including prophylactic heparin therapy, is crucial for reducing adverse outcomes.

Area of Science:

  • Reproductive Medicine
  • Hematology
  • Genetics

Background:

  • Heritable coagulopathies are a major cause of maternal thromboembolism.
  • Common disorders include antithrombin III deficiency, protein C/S deficiency, Factor V Leiden mutation, prothrombin gene mutation, and hyperhomocysteinemia.

Purpose of the Study:

  • To describe heritable coagulopathies complicating pregnancy.
  • To state their adverse effects on maternal and perinatal outcomes.
  • To explain management strategies during pregnancy.

Main Methods:

  • Review of literature on heritable coagulopathies and pregnancy outcomes.
  • Analysis of risks associated with specific genetic thrombophilias.
  • Outline of current management guidelines for thromboembolism prophylaxis and treatment.

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Main Results:

  • Heritable coagulopathies increase maternal thromboembolism risk eightfold.
  • These conditions elevate stillbirth risk by 3.6-fold and are linked to intrauterine growth retardation and preeclampsia.
  • Management involves therapeutic heparin for acute events and prophylactic therapy for high-risk individuals.

Conclusions:

  • Proper management of heritable coagulopathies is essential to mitigate risks during pregnancy.
  • Antithrombin III deficiency requires full therapeutic heparin throughout pregnancy.
  • Postpartum anticoagulation with heparin or warfarin is necessary for all patients.