title: Thrombophilia-associated pregnancy wastage.
abstract: OBJECTIVE
  To critically review the literature regarding inherited thrombophilia and recurrent fetal loss.
  
  
  METHODS
  English-language literature review.
  
  
  METHODS
  Women who experienced repeated pregnancy wastage.
  
  
  METHODS
  Aspirin, glucocorticoids, heparin, and IV immunoglobulin for the prevention of miscarriage.
  
  
  METHODS
  Live birth, miscarriage, preeclampsia, and pregnancy loss.
  
  
  RESULTS
  Recurrent fetal loss and other placental vascular pathologies of pregnancy have long been associated with antiphospholipid syndrome, an acquired autoimmune thrombophilic state. The number of known heritable thrombophilic disorders has grown rapidly in recent years with the identification of activated protein C resistance, factor V Leiden mutation, and hyperhomocysteinemia as major causes of thrombosis. Data accumulated over the past 2 years suggest that heritable thrombophilia is associated with an increased risk of fetal loss and preeclampsia. The present review discusses potential pathogenetic mechanisms for this association and evaluates reported therapeutic regimens for the prevention of fetal loss in women with thrombophilia.
  
  
  CONCLUSIONS
  Placental thrombosis may be the final common pathophysiologic pathway in most women with habitual abortions and repeated pregnancy wastage. Prophylactic antithrombotic therapy is indicated in women with heritable thrombophilia and antiphospholipid syndrome and probably is more effective than the previously used modalities of prednisone, aspirin, and IV immunoglobulin.
authors.affiliation: Reproductive Endocrinology, Department of Obstetrics and Gynecology, Rambam Medical Center, Haifa, Israel. bzeev@techunix.technion.ac.il
authors.forename: Z
authors.initials: Z
authors.lastname: Blumenfeld
authors.forename: B
authors.initials: B
authors.lastname: Brenner
mesh_terms: D000026:Abortion, Habitual / Q000150:complications* / Q000517:prevention & control; D016736:Antiphospholipid Syndrome / Q000150:complications; D020152:Antithrombin III Deficiency / Q000150:complications; D005260:Female; D005337:Fibrin / Q000096:biosynthesis; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications; D011247:Pregnancy; D011486:Protein C / Q000378:metabolism; D011516:Prothrombin / Q000235:genetics; D019851:Thrombophilia / Q000235:genetics*
chemical_list: D011486:Protein C; D011516:Prothrombin; D005337:Fibrin