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Antenatal screening for factor V Leiden mutation: a critical appraisal
D J Rouse1, R L Goldenberg, K D Wenstrom
1Department of Obstetrics and Gynecology, University of Alabama at Birmingham, USA.
Obstetrics and Gynecology
|November 14, 1997
Summary
Routine screening for the factor V Leiden mutation in pregnant individuals is not recommended. While this genetic mutation increases thrombosis risk, current evidence does not support widespread antenatal screening for factor V Leiden.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Medical Genetics
Background:
- Thromboembolic disease is a significant cause of maternal mortality in the US.
- Inherited resistance to activated protein C, primarily due to the factor V Leiden mutation, is a major thrombosis risk factor.
- The factor V Leiden mutation is found in 5% of whites and 1% of blacks in the US.
Purpose of the Study:
- To evaluate the suitability of routine antenatal screening for the factor V Leiden mutation.
- To assess screening feasibility based on established criteria for successful public health screening programs.
Main Methods:
- Conducted a combined MEDLINE and bibliographic literature search.
- Evaluated available data on the factor V Leiden mutation and screening program characteristics.
Main Results:
- The factor V Leiden mutation is the most common cause of inherited thrombophilia.
- Screening criteria evaluation suggests current limitations for routine antenatal application.
- The mutation's prevalence necessitates careful consideration for screening strategies.
Conclusions:
- Routine antenatal screening for the factor V Leiden mutation is not currently recommended.
- Further research and evaluation are needed before implementing widespread screening programs.
- Clinical judgment remains paramount in managing thrombosis risk during pregnancy.