Volumen: 20 # Number : 1
Publication Date : Enero - Abril Year: 2016
Pregnancy complications and thrombophilia
Authors: Grand BE.
Abstract: Pregnancy is a prothrombotic state and a pathological
exaggeration of this hypercoagulability has been
linked to placenta mediated complications. These
problems include both early (recurrent miscarriages)
and late placental vascular complications (fetal
loss, pre-eclampsia, placental abruption and intrauterine
growth restriction). The risks of these
complications can be higher in the presence of an
acquired or inherited thrombophilia. The most
commonly reported form of acquired thrombophilia
is the antiphospholipid syndrome (APS). At present
routine screening of inherited thrombophilia in
these disorders are not recommended in the absence
of venous thromboembolism.
Low dose of aspirin and low molecular weight heparin (LMWH) have proven their effectiveness
in increasing live birth rates in the setting of the
APS. However their use in the context of inherited
thrombophilia and pregnancy complications is not
well established. The results of an ongoing trial of
LMWH in women with recurrent pregnancy loss
and hereditary thrombophilia are being waiting
(ALIFE2). There is however no benefit of LMWH
treatment in preventing recurrent miscarriage in
women without thrombophilia.
Future research is directed for the use of heparin in
women with pregnancy complications mediated by
placenta, selected by previous pregnancy outcome
and not by thrombophilic defect.
Key words: hereditary thrombophilia,
recurrent pregnancy loss,
obstetric antiphospholipid syndrome
Pages :
|
