Pregnancy and Thrombophilia

Abstract

Thrombophilic disorders encompass a diverse group of coagulation disorders that potentiate a predisposition for thrombotic events. Amongst the known thrombophilias are antithrombin III deficiency, prothrombin G20210A gene mutation, protein S and protein C deficiency, activated protein C resistance and the antiphospholipid syndrome. Thrombophilia and its influence on pregnancy have been studied for the past 50 years. Both inherited and acquired thrombophilia have been associated with an increased risk of thrombo-embolism as well as an increased risk of pregnancy loss and adverse obstetric outcomes. Some thrombophilias (antiphosphoplipid syndrome, factor V Leiden mutation and antithrombin III deficiency confer a higher risk of both venous thrombo-embolism and obstetric complications. There is still no consensus on the optimal management of thromboprophylaxis in future pregnancies. Clearly large well designed and adequately powered multicenter randomised trials are required to clarify the management of thrombophilia in pregnancy especially with a history of adverse obstetric outcome.