[Inherited thrombophilia and pregnancy].
Inherited thrombophilia include deficiences of antithrombin III, protein C and protein S, and the factor V Leiden mutation, the prothrombin gene variant, and homozygosity for the thermolabile variant of methylenetetrahydrofolate reductase (MTHFR). The incidence of thromboembolism events during pregnancy and postpartum period among women with thrombophilia is not well known and depends on the prethrombotic state resulting from the interaction of the underlying thrombophilic defect(s), history of congenital thrombophilia, and additional risk factors. In that way, many patients with congenital thrombophilia will require antenatal thromboprophylaxis, the timing of which will depend on the patient's history and thrombophilic disorders. Low molecular weight heparin appeared to be a safe alternative to unfractionated heparin for both the fetus and the mother during the pregnancy. Case-control studies have recently demonstrated that serious obstetrical complications i. e severe preeclampsia, abruptio placentae, intrauterine growth restriction, and stillbirth were frequently associated with inherited thrombophilia. Controlled trials are now urgently needed to determine the possible potential benefits of anticoagulant therapy in pregnancy outcome. Finally, there is no evidence to support routine screening for congenital thrombophilia during pregnancy.
Verspyck
E
E
Service de Gynécologie-Obstétrique, CHU, Rouen, France.
Le Cam-Duchez
V
V
Borg
J Y
JY
Marpeau
L
L
D020152:Antithrombin III Deficiency / Q000235:genetics; D004351:Drug Resistance / Q000235:genetics; D005260:Female; D006801:Humans; D009154:Mutation; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic; D011486:Protein C; D011516:Prothrombin / Q000235:genetics; D019851:Thrombophilia / Q000150:complications / Q000235:genetics*; D013927:Thrombosis / Q000209:etiology
D011486:Protein C; D011516:Prothrombin