title: Screening and management of inherited thrombophilias in the setting of adverse pregnancy outcome.
abstract: Inherited thrombophilic conditions are associated with adverse pregnancy outcomes, including severe pre-eclampsia, fetal loss, abruptio placentae, and intauterine growth restriction. Although the prevalence of these complications is approximately 8% in the general population, their presence is associated with a significantly increased recurrence risk. Thrombophilic conditions most strongly associated with adverse pregnancy outcome include factor V Leiden, prothrombin gene mutation, and deficiencies of protein S, protein C, and antithrombin. Other thrombophilic conditions, such as protein Z deficiency, also appear to be associated with an increased risk of pregnancy complications. Antenatal administration of heparin to prevent pregnancy complications has shown promise in small studies, but a randomized, placebo-controlled trial is necessary to determine whether heparin administration is beneficial in preventing adverse pregnancy outcome.
authors.affiliation: The Program for Thrombosis and Hemostasis in Women's Health, Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, 333 Cedar Street, 329 FMB, New Haven, CT 06520-8063, USA. michael.paidas@yale.edu
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Paidas
authors.forename: De-Hui W
authors.initials: DH
authors.lastname: Ku
authors.forename: Yale S
authors.initials: YS
authors.lastname: Arkel
mesh_terms: D000037:Abruptio Placentae / Q000209:etiology; D000925:Anticoagulants / Q000008:administration & dosage*; D004461:Eclampsia / Q000209:etiology; D005260:Female; D005313:Fetal Death / Q000209:etiology; D005317:Fetal Growth Retardation / Q000209:etiology; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D011225:Pre-Eclampsia / Q000209:etiology; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic; D011256:Pregnancy Outcome; D019851:Thrombophilia / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy*
chemical_list: D000925:Anticoagulants; D006493:Heparin