[Thrombophilias and vascular placental pathology. A survey of the literature].
OBJECTIVE
Hereditary thrombophilia as antiphospholipid syndrome (APS) may represent a new risk factor for placental vascular diseases.


BACKGROUND
General screening for biological abnormalities related to thrombophilia is poorly associated with placental vascular diseases and therefore, may be unwarranted. Women with an history of thrombotic diseases may be at risk for late fetal loss or preeclampsia. Adverse obstetric outcomes are particularly high despite anticoagulation regimens in patients with APS. A high frequency for biological abnormalities related to thrombophilia was detected in pregnancies complicated by late fetal loss in comparison with controls. However, no beneficial strategy prevention was clearly reported and therefore, a selective testing was actually debated for these patients.


CONCLUSIONS
Searching for acceptable treatment alternatives in patients with APS in order to reduce the high rate for pregnancy complications which may be persistent despite anticoagulation regimens. To determine by controlled studies the role for a prophylactic low molecular weight heparin regimens in patients with haemostatic abnormalities and previous pregnancy complications.
Verspyck
E
E
Service de gynécologie-obstétrique, CHU Charles Nicolle, 76000 Rouen cedex, France.
Marpeau
L
L
D020016:Activated Protein C Resistance / Q000175:diagnosis / Q000188:drug therapy; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000188:drug therapy; D001241:Aspirin / Q000008:administration & dosage / Q000627:therapeutic use; D015331:Cohort Studies; D016001:Confidence Intervals; D004359:Drug Therapy, Combination; D005260:Female; D005313:Fetal Death / Q000209:etiology*; D005317:Fetal Growth Retardation / Q000209:etiology*; D005544:Forecasting; D006710:Homocysteine / Q000097:blood; D006801:Humans; D007231:Infant, Newborn; D015201:Meta-Analysis as Topic; D015999:Multivariate Analysis; D016017:Odds Ratio; D010920:Placenta / Q000098:blood supply*; D010922:Placenta Diseases / Q000150:complications / Q000517:prevention & control; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000209:etiology*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D019851:Thrombophilia / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control; D013927:Thrombosis / Q000150:complications / Q000188:drug therapy / Q000517:prevention & control
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D006710:Homocysteine; D001241:Aspirin