Thrombophilia in pregnacy
J. Chudej; I. Plameňová; J. Hudeček
Authors‘ workplace: Klinika hematológie a transfuziológie, Národné centrum pre hemostázu a trombózu, Jesseniova lekárska fakulta UK, Martin, Slovensko, primár MUDr. J. Hudeček, PhD.
Published in: Ceska Gynekol 2015; 80(6): 421-425
Bring a comprehensive overview of the available knowledge about thrombophilia in pregnat women.
Departmentof Haematology and Transfusion Medicine, National Centre for Haemostasis and Thrombosis, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia.
Analysis of literary sources.
Anticoagulation may provide benefit for women both as prophylaxis and as treatment for venous thrombosis during pregnancy. The use of anticoagulants in women with inherited thrombophilia and history of miscarriage remains controversial. In contrast, pregnant women with acquired thrombophilia should be anticoagulated.
trombophilia, pregnacy, complications
1. Bates, SM. Consultative haematology: the pregnant patient. Hematology, 2010, 1, p. 166–172.
2. Bates, SM. Anticoagulation and in vitro fertilization andovarian stimulation. Hematology 2014. American Society of Hematology Education Program: American Society of Hematology, Washington DC, 2014, p. 379–386.
3. Branch, DW., Khamashta, MA. Antiphospholipid syndrome: obstetric diagnosis, management and controversies. Obstet Gynaecol, 2003, 101, p. 1333–1344.
4. Brenner, B., Hoffman, R., Carp, H., et al. Efficacy and safety of two doses of enoxaparin in women with thrombophilia and recurrent pregnancy losses: the LIVE–ENOX study. J Thromb Haemost, 2005, 3, p. 227–229.
5. Cowchock, FS., Reece, EA., Balaban, D., et al. Repeated fetal losses associated with antiphospholipid antibodies: a collaborative randomized trial comparing prednisone with low-dose heparin treatment. Am J Obstet Gynecol, 1992, 166, p. 1318–1323.
6. Dekker, GA., de Vries, JI., Doelitzsch, PM., et al. Underlying disorders associated with severe early-onset preeclampsia. Am J ObstetGynecol, 1995, 173, p. 1042–1048.
7. Dizon-Townson, DS., Nelson, LM., Easton, K., Ward, K. The factor V Leiden mutation may predispose women to severe preeclampsia. Am J Obstet Gynecol, 1996, 175, p. 902–905.
8. Dizon-Townson, D., Miller, C., Sibai, B., et al. The relationship of factor V Leiden mutation and pregnancy outcomes for mother and fetus. Obstet Gynecol, 2005, 106, p. 517–524.
9. Farquharson, RG., Quenby, S., Greaves, M. Antiphospholipid syndrome in pregnancy: a randomized, controlled trial of treatment. Obstet Gynecol, 2002, 100, p. 408–413.
10. Grandone, E., Brancaccio, V., Colaizzo, D., et al. Preventing adverse obstetric outcomes in women with genetic thrombophilia. Fertil Steril, 2002,78, p. 371–375.
11. Kubisz, P., Staško, J., Dobrotová, M., et al. Hematológia a transfuziológia. Praha: Grada Publishing, 2006, s. 323.
12. Kujovich, JL. Thrombophilia and pregnancy complications. Am J Obstet Gynecol, 2004, 191(2), p. 412–424.
13. Kupferminc, MJ., Eldor, A., Steinman N., et al. Increased frequency of genetic thrombophilia in women with complications of pregnancy. N Engl J Med, 1999, 340, p. 9–13.
14. Kupferminc, MJ., Fait, G., Many A., et al. Low molecular weightheparin for the prevention of obstetric complications in women with thrombophilias. Hypertens Pregnancy, 2001, 20, p. 35–44.
15. Kutteh, WH. Antiphospholipid antibody-associated recurrent pregnancy loss: treatment with heparin and low-dose aspirin is superior to low-dose aspirin alone. Am J Obstet Gynecol, 1996, 174, p. 1584–1589.
16. Laskin, CA., Bombardier, C., Hannah, ME., et al. Prednisone and aspirin in women with autoantibodies and unexplained recurrent fetal loss. N Engl J Med, 1997, 337, p. 148–154.
17. Lassere, M., Empson, M. Treatment of antiphospholipid syndrome in pregnancy: a systematic review of randomized therapeutic trials. Thromb Res, 2004, 114, p. 419–426.
18. Lattová, V., Dostál, J., Pešková, M., et al. Opakované selhání implantace embrya a trombofílie. Čes Gynek, 2015, 80(1), s. 5–10.
19. Lin, L., August, P. Genetic thrombophilias and preeclampsia: a meta-analysis. Obstet Gynecol, 2005, 105, p. 182–192.
20. Lissalde-Lavigne, G., Fabbro-Peray, P., Cochery-Nouvellon, E., et al. Factor V Leiden and prothrombin G20210A polymorphisms as risk factors for miscarriage during a first intended pregnancy: the matched case control 'NOHA first' study. J Thromb Haemost, 2005, 3, p. 2178–2184.
21. Martinelli, I., Taioli, E., Cetin, I., et al. Mutations in coagulation factors in women with unexplained late fetal loss. N Engl J Med, 2000, 343, p. 1015–1018.
22. McCowan, LME., Craigie, S., Taylor, RS., et al. Inherited thrombophilias are not increased in "idiopathic" small-for-gestationalage pregnancies. Am J Obstet Gynecol, 2003, 188, p. 981–992.
23. McNamee, K., Dawood, F., Farquharson, RG. Recurrent miscarriage and thrombophilia: an update. Curr Opin Obstet Gynecol, 2012, 24, p. 1–6.
24. Middeldorp, S. Anticoagulation in pregnancy complications. American Society of Hematology Education Program. Hematology 2014. American Society of Hematology Education Program: American Society of Hematology, Washington DC, 2014, p. 393–399.
25. Pattison, NS., Chamley, LW., Birdsall, M., et al. Does aspirin have a role in improving pregnancy outcome for women with the antiphospholipid syndrome? A randomized controlled trial. Am J Obstet Gynecol, 2000, 183, p. 1008–1012.
26. Prisco, D., Ciuti, G., Falciani, M. Hemostatic changes in normal pregnacy. Haematol Reports, 2005, 1(10), p. 1–5.
27. Rai, R., Cohen, H., Dave, M., Regan, L. Randomised controlled trial of aspirin and aspirin plus heparin in pregnant women with recurrent miscarriage associated with phospholipid antibodies (or antiphospholipid antibodies). BMJ, 1997, 314, p. 253–257.
28. Ridker, PM., Miletich, JP., Buring, JE., et al. Factor V Leiden mutation as a risk factor for recurrent pregnancy loss. Ann Intern Med, 1998, 128, p. 1000–1003.
29. Rivard, C., Rivard, GE., Yotov, WV., et al. Absence of association of thrombophilia polymorphisms with intrauterine growth restriction. N Engl J Med, 2002, 347, p. 19–25.
30. Ruiz-Irastorza, G., Crowther, M., Branch, W., et al. Antiphospholipid syndrome. Lancet, 2010, 376, p. 1498–1509.
31. Sabadell, J., Castellas, M., Alijotas-Reig, J., et al. Inherited antithrombin deficiency and pregnancy: maternal and fetal outcomes. Eur J Obstet Gynecol Reprod Biol, 2010, 149, p. 47–51.
32. Sarig, G., Younis, J., Hoffman, R., et al. Thrombophilia is common in women with idiopathic pregnancy loss and is associated with late pregnancy wastage. Fertil Steril, 2002, 77, p. 342–347.
33. Saiter, MS., Finan, RR., Al-Hammad, S. A high frequency of antiprotein Z IgM and IgG autoantibodies in women with idiopathic recurrent spontaneous miscarriage. Am J Reprod Immunol, 2011, 65, p. 526–531.
34. Sellman, JS., Holman, RL. Thromboembolism during pregnancy. Risks, challengies and recommendations. Postgrad Med, 2000, 108(4), p. 71–84.
35. Sibai, BM., How, HY., Stella, CL. Thrombophilia in pregnancy: Whom to screen, when to treat. OBG Management, 2007, 19, p. 50–64.
36. Silver, RK., MacGregor, SN., Sholl, JS., et al. Comparative trial of prednisone versus aspirin alone in the treatment of anticardiolipin antibody-positive obstetric patients. Am J Obstet Gynecol, 1993, 169, p. 1411–1417.
37. Simonova, R., Bartosova, L., Chudy, P., et al. Nine kindreds of familial sticky platelet syndrome phenotype. Clin Appl Thromb Hemost, 2013, 19(4), p, 395–401.
38. Sokol, J., Biringer, K., Skerenova, M., et al. Platelet aggregation abnormalities in patients with fetal losses: the GP6 gene polymorphism. Fertil Steril, 2012, 98(5), p. 1170–1174.
39. Sokol, J., Biringer, K., Skerenova, M., et al. Activity of coagulation factor XI in patients with spontaneous miscarriage: The presence of risk alleles. J Obstet Gynaecol, 2014, 17, p. 1–4.
40. Sokol, J., Biringer, K., Skerenova, M., et al. Different models of inheritance in selected genes in patients with sticky platelet syndrome and fetal loss. Semin Thromb Hemost, 2015, 41(3), p. 330–335.
41. Tranquilli, A. Thrombophilia. In Tech Europe. Rijeka: 2011, p. 226.
42. Verspyck, E., Borg, JY., Le Cam-Duchez, V., et al. Thrombophilia and fetal growth restriction. Eur J Obstet Gynecol Reprod Biol, 2004, 113, p. 36–40.
43. Visser, J., Ulander, VM., Helmerhorst, FM., et al. Thromboprophylaxis for recurrent miscarriage in women with or without thrombophilia. HABENOX: a randomised multicentre trial. Thromb Haemost, 2010, 105, p. 295–301.
LabelsPaediatric gynaecology Gynaecology and obstetrics Reproduction medicine
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