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Related Experiment Videos

Risk factors for pregnancy associated venous thromboembolism

M D McColl1, J E Ramsay, R C Tait

  • 1Department of Haematology, Royal Infirmary, Glasgow, Scotland, UK.

Thrombosis and Haemostasis
|November 19, 1997
PubMed
Summary

Screening all pregnant women for factor V Leiden mutation is not recommended. The study found the thrombotic risk for carriers is low, suggesting current screening practices are not cost-effective for reducing pregnancy-associated venous thromboembolism.

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Area of Science:

  • Obstetrics and Gynecology
  • Hematology
  • Thrombosis Research

Background:

  • Pregnancy-associated venous thromboembolism (PA-VTE) is a significant concern.
  • Screening for factor V Leiden mutation in early pregnancy is proposed to reduce PA-VTE incidence.
  • The utility of universal screening remains debated.

Purpose of the Study:

  • To evaluate the effectiveness of screening all pregnant women for the factor V Leiden mutation.
  • To determine the incidence of PA-VTE and associated thrombophilic abnormalities.
  • To assess the thrombotic risk for women with factor V Leiden mutation during pregnancy and puerperium.

Main Methods:

  • A large retrospective study involving over 72,000 deliveries.
  • Objective confirmation of venous thrombotic events, including deep vein thrombosis (DVT) and pulmonary embolism (PE).

Related Experiment Videos

  • Thrombophilia screening for women with PA-VTE, including antithrombin deficiency and factor V Leiden mutation testing.

    • Main Results:

    • The incidence of DVT was 0.71 per 1000 deliveries, and PE was 0.15 per 1000 deliveries.
    • 28% of PA-VTE episodes lacked clinical risk factors or identifiable thrombophilic abnormalities.
    • Factor V Leiden mutation was found in 8% of screened individuals, with an estimated pregnancy/puerperium thrombotic risk of 1 in 400-500 for carriers.

    Conclusions:

    • The estimated thrombotic risk for factor V Leiden mutation carriers during pregnancy or puerperium is approximately 1 in 400-500.
    • This risk level does not support routine, random screening for the factor V Leiden mutation in early pregnancy.
    • Current evidence suggests universal screening is not a cost-effective strategy for PA-VTE prevention.