[Preventing adverse obstetric outcome in women with thrombophilia]

Thrombophilia may represent a new risk factor for placental vascular disorders. Thromboprophylaxis with low doses of heparin and aspirin may be discussed in order to reduced adverse obstetric outcomes. No randomized controlled trials are currently published in the literature. Thromboprophylaxis may be unwarranted in asymptomatic women because of the lack for an association between thrombophilia and pregnancy outcome. Women with antiphospholipid syndrome are at high risk for pregnancy loss and maternal complications. Pregnancy in women with antiphospholipid syndrome appears to be improved by thromboprophylaxis, but adverse obstetric outcome may occur despite treatment. Thromboprophylaxis is recently reported in women with previous poor obstetric outcomes. These preliminary observational studies are still insufficient to recommend a large diffusion for thromboprophylaxis. Prevention for adverse outcomes with a low fixed dose of heparin may only be discussed in women with previous late fetal loss or intrauterine fetal death.