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Measurement of Factor V Activity in Human Plasma Using a Microplate Coagulation Assay
Published on: September 9, 2012
Inherited and acquired thrombophilias
Marianna Pina Rambaldi1, Federico Mecacci, Secondo Guaschino
11High Risk Pregnancy Unit, University Hospital of Careggi, Florence, Italy.
Reproductive Sciences (Thousand Oaks, Calif.)
|August 1, 2013
Summary
Thrombophilia in pregnancy presents challenges. Anticoagulation shows no benefit for inherited thrombophilia and recurrent pregnancy loss, with its use for other complications remaining experimental.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Reproductive Medicine
Background:
- Thrombophilias, including inherited mutations (Factor V Leiden, prothrombin G20210A, MTHFR C667T) and acquired conditions (antiphospholipid antibody syndrome, hyperhomocysteinemia), complicate pregnancy.
- These conditions are associated with placenta-mediated complications, necessitating careful management strategies.
- Controversy exists regarding optimal care for obstetrical patients with thrombophilia.
Purpose of the Study:
- To review the current understanding of thrombophilias in pregnancy.
- To assess the efficacy of anticoagulation for placenta-mediated complications in inherited thrombophilia.
- To outline current treatment recommendations for antiphospholipid antibody syndrome in pregnancy.
Main Methods:
- Review of prospective cohort studies assessing risks of inherited thrombophilia.
- Analysis of placebo-controlled, randomized trials on anticoagulation for recurrent pregnancy loss.
- Evaluation of treatment strategies for antiphospholipid antibody syndrome during gestation.
Main Results:
- Prospective studies accurately assessed risks of placenta-mediated complications from inherited thrombophilias.
- Randomized trials demonstrated no benefit of anticoagulation for inherited thrombophilia with recurrent pregnancy loss.
- Anticoagulation for other placenta-mediated complications in inherited thrombophilia is considered experimental pending further trials.
Conclusions:
- The role of anticoagulation in inherited thrombophilia during pregnancy requires further investigation, particularly for non-recurrent pregnancy loss complications.
- Antiphospholipid antibody syndrome in pregnancy is effectively managed with heparin anticoagulation and antiplatelet therapies.
- Care providers and obstetrical patients face evolving challenges in managing thrombophilias during pregnancy.
Keywords:
abortionabruptionacquired thrombophiliaadverse pregnancy outcomefetal demiseinherited thrombophiliaintrauterine growth restrictionpreeclampsiapregnancythrombophiliaMore Related Videos
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