Acquired thrombophilia in pregnancy

Thromboembolic disease remains the most frequent cause of perinatal mortality in the Western world. Much has been written about the management of patients with underlying inherited thrombophilic disorders during pregnancy. However, a number of factors, such as age over 35 years, multiparity, and cesarean section are strong predictors of an increased risk of venous thrombosis and pulmonary embolus. Poorly controlled hypertension, especially in the setting of preeclampsia and eclampsia, is a risk factor for stroke. Appropriate preventive guidelines in these settings must be developed. In addition, various acquired preexisting conditions are associated with thromboembolic disease during pregnancy. In this article, the acquired syndromes of ovarian vein thrombosis, essential thrombocythemia, antiphospholipid syndrome, and cardiac valvular disease during pregnancy will be discussed, and the appropriate preventive and therapeutic interventions for these conditions will be reviewed. Proper management of acquired thrombophilia during pregnancy requires vigilance and a thorough understanding of the risks associated with the condition and its therapy.