The role of factor V Leiden mutation in recurrent pregnancy loss

Although recurrent pregnancy loss is rare, it is a major health problem. Fewer than 50% of cases have definitive causes. Thrombophilias such as factor V Leiden mutation may be responsible for a portion of the unexplained cases. In recent years, a number of studies have reached conflicting conclusions about the role of factor V Leiden in recurrent pregnancy loss. This article reviews the current literature. It appears that factor V Leiden mutation may be associated with stillbirth as well as with some poor pregnancy outcomes. The mutation may also be linked to first-trimester loss. Prospective case-controlled studies to better answer many of the questions concerning the role of this mutation in recurrent pregnancy loss and to determine optimal treatment may not be feasible because it is so rare. At this point, treatment involves anticoagulation and is based on observational studies and expert opinion.