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[Inherited thrombophilia and pregnancy]
E Verspyck1, V Le Cam-Duchez, J Y Borg
1Service de Gynécologie-Obstétrique, CHU, Rouen, France.
Summary
Women with inherited thrombophilia face higher risks of pregnancy complications. Anticoagulant therapy may offer benefits, but routine screening for thrombophilia during pregnancy is not recommended.
Area of Science:
- Obstetrics
- Hematology
- Genetics
Context:
- Inherited thrombophilia encompasses genetic conditions like Factor V Leiden and deficiencies in proteins C, S, and antithrombin III.
- Pregnancy and postpartum periods present unique risks for thromboembolism in women with thrombophilia.
- The precise incidence of these events and associated risk factors remain incompletely understood.
Purpose:
- To review the current understanding of inherited thrombophilia in pregnancy.
- To discuss the association between thrombophilia and adverse obstetrical outcomes.
- To evaluate the role of thromboprophylaxis and the need for further research.
Summary:
- Inherited thrombophilia increases the risk of serious obstetrical complications, including preeclampsia, abruptio placentae, intrauterine growth restriction, and stillbirth.
- Low molecular weight heparin is considered a safe option for antenatal thromboprophylaxis.
- While case-control studies suggest a link, controlled trials are needed to confirm the benefits of anticoagulant therapy on pregnancy outcomes.
Impact:
- Highlights the association between inherited thrombophilia and adverse pregnancy outcomes, emphasizing the need for careful patient management.
- Underscores the current lack of evidence supporting routine screening for inherited thrombophilia in pregnant individuals.
- Identifies critical areas for future research, particularly controlled trials on anticoagulant therapy to improve pregnancy outcomes.