Thrombophilia, thrombosis and pregnancy

Area of Science:

• Obstetrics and Gynecology
• Hematology
• Thrombosis Research

Background:

• Pregnancy elevates venous thromboembolism (VTE) risk sixfold, with pulmonary embolism being the primary cause of maternal mortality.
• Risk factors for VTE in pregnancy include advanced maternal age, prior VTE, Cesarean delivery, and thrombophilia.
• Thrombophilia is prevalent in women with obstetric complications like recurrent miscarriage and pre-eclampsia, linked to placental microvascular thrombosis.

Purpose of the Study:

• To review the risk factors and management strategies for venous thromboembolism (VTE) during pregnancy.
• To highlight the role of thrombophilia in obstetric complications and VTE.
• To discuss the current therapeutic approaches, emphasizing low-molecular-weight heparins (LMWHs).

Main Methods:

• Literature review of studies on VTE in pregnancy.
• Analysis of risk factors including thrombophilia and obstetric history.
• Evaluation of antithrombotic therapies, comparing LMWHs with oral anticoagulants and unfractionated heparin.

Main Results:

• VTE risk in pregnancy is substantial, necessitating careful risk assessment.
• Thrombophilia is common in women with adverse pregnancy outcomes and increases VTE risk.
• Low-molecular-weight heparins (LMWHs) are effective and preferred for VTE prevention and treatment in pregnancy, improving obstetric outcomes.

Conclusions:

• Individualized VTE management during pregnancy is essential, considering patient-specific risk factors.
• LMWHs represent a safer and more effective alternative to oral anticoagulants for managing VTE in pregnant women.
• Proactive thromboprophylaxis and treatment strategies are vital for improving maternal and fetal outcomes in high-risk pregnancies.