title: Does asymptomatic carriage of FV Leiden and FII prothrombin mutations in heterozygous configuration pose an increased risk of thrombembolic complications in the course of pregnancy, labor and puerperium?
abstract: OBJECTIVE
  To evaluate the course of pregnancy and puerperium in asymptomatic carriers of FV Leiden and FII prothrombin mutation in heterozygous configuration in terms of risk of thrombembolic disease (TED) and late pregnancy complications. To evaluate whether global prophylactic LMWH administration during pregnancy benefits these women.
  
  
  METHODS
  We monitored the incidence of thrombembolic events and severe late pregnancy complications in 473 asymptomatic carriers of FV Leiden and FII prothrombin mutation in heterozygous configuration. In 253 women, preventive LMWH application was introduced already during pregnancy. In 220 women, the application of LMWH was commenced as late as on the delivery day. In both groups application of LMWH continued during the puerperium.
  
  
  RESULTS
  The incidence of TED in the whole group of carriers of thrombophylic mutations accounted for 0.19%. The incidence of severe late pregnancy complications was low - 2.5% compared with general population of pregnant women (6.4%).
  
  
  CONCLUSIONS
  No direct causal relationship was established between asymptomatic carriage of Leiden and prothrombin mutation in heterozygous configuration and the occurrence of severe late pregnancy complications. There was no benefit from general LMWH prophylaxis started as early as pregnancy in these women and thus we consider it unnecessary.
authors.affiliation: Department of Obstetrics and Gynaecology, 2nd Faculty of Medicine, Charles University in Prague and Teaching Hospital Motol, Prague, Czech Republic.
authors.forename: Blanka
authors.initials: B
authors.lastname: Vavrinkova
authors.forename: Tomas
authors.initials: T
authors.lastname: Binder
authors.forename: Ivana
authors.initials: I
authors.lastname: Hadacova
authors.forename: Ingrid
authors.initials: I
authors.lastname: Hrachovinova
authors.forename: Peter
authors.initials: P
authors.lastname: Salaj
authors.forename: Martin
authors.initials: M
authors.lastname: Hruda
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D005165:Factor V / Q000235:genetics*; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006579:Heterozygote; D006801:Humans; D015994:Incidence; D009154:Mutation; D007744:Obstetric Labor Complications / Q000453:epidemiology / Q000235:genetics* / Q000517:prevention & control; D049590:Postpartum Period; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology / Q000235:genetics* / Q000517:prevention & control; D011516:Prothrombin / Q000235:genetics*; D012307:Risk Factors; D013923:Thromboembolism / Q000453:epidemiology / Q000235:genetics* / Q000517:prevention & control
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; C095381:factor V Leiden; D005165:Factor V; D011516:Prothrombin