| January 2007 · Vol. 19, No. 01
Thrombophilia in pregnancy: Whom to screen, when to treat
Despite extensive research on testing and prophylaxis, a cautious approach is warranted
|
Fast Track
Antiphospholipid antibody syndrome is the most common acquired thrombophilia of pregnancy
A study of >5,000 asymptomatic gravidas found no association between abruptio placenta and factor V Leiden mutation
Carriers of factor V or prothrombin gene mutations are at higher risk of late fetal loss than noncarriers are
Screen women with a prior adverse pregnancy outcome for thrombophilia; without treatment, their risk of another adverse outcome ranges from 66% to 83%
The risk of VTE during pregnancy and postpartum for women who have antithrombin deficiency and a history of VTE is roughly 40%
Proceed in the half-dark: Your care of the thrombophilic pregnant woman is not yet illuminated by rigorous clinical trials
|
|
Baha
M.
Sibai,
MDProfessor, Department of Obstetrics and Gynecology, University of Cincinnati, Cincinnati, Ohio Helen
Y.
How,
MDAssociate Professor, Department of Obstetrics and Gynecology, University of Cincinnati, Cincinnati, Ohio Caroline
L.
Stella,
MDMaternal–Fetal Medicine Fellow, Department of Obstetrics and Gynecology, University of Cincinnati, Cincinnati, Ohio
Thrombophilia has been widely investigated—and that may be one of the main challenges in detecting and managing it during pregnancy: Numerous studies have yielded different estimates of the incidence of various clotting disorders in pregnancy—itself a hypercoagulable state—and conflicting screening and prevention recommendations. The authors offer whatever recommendations have emerged.
|
