title: Prophylaxis and treatment of thrombophilia in pregnancy.
abstract: OBJECTIVE
  This review addresses the prophylaxis and treatment of thrombophilia in pregnancy, which is associated with increased risk of venous thromboembolism and placental vascular complications.
  
  
  RESULTS
  Topics include preventing deep vein thrombosis recurrence in pregnant women with constitutional thrombophilias, using prophylactic heparins throughout pregnancy and postpartum anticoagulants. Cases of thrombosis still occur in the postpartum period and other therapeutics should be tested. Primary prophylaxis is acceptable for high-risk thrombophilias. Early pregnancy losses (before the 10th week) are not associated with constitutional thrombophilias. The natural prognosis of embryonic losses associated with current thrombogenic polymorphisms is good, unlike fetal losses associated with the same thrombophilias: in this case, a prophylactic low-molecular-weight heparin given from the beginning of the 8th week is more efficient than low-dose aspirin. Data are lacking on the prevention of severe preeclampsia, placental abruption, or intrauterine growth restriction in women with constitutional thrombophilias; preliminary results indicate that low-molecular-weight heparin may have some preventive effect. Specific studies are needed.
  
  
  CONCLUSIONS
  Recent studies have shown the limits of available procedures for women with constitutional thrombophilia and have helped define the clinical situations in thrombophilia-related placental insufficiency in which prophylactic low-molecular-weight heparin may be indicated.
authors.affiliation: Department of Hematology, University Hospital, Nîmes, France.jean.christophe.gris@chu-nimes.fr
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Gris
authors.forename: Géraldine
authors.initials: G
authors.lastname: Lissalde-Lavigne
authors.forename: Isabelle
authors.initials: I
authors.lastname: Quéré
authors.forename: Michel
authors.initials: M
authors.lastname: Dauzat
authors.forename: Pierre
authors.initials: P
authors.lastname: Marès
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy* / Q000517:prevention & control; D011256:Pregnancy Outcome; D019851:Thrombophilia / Q000150:complications / Q000188:drug therapy* / Q000517:prevention & control
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight