Review article
THROMBOPHILIA AND ITS INFLUENCE ON THE PREGNANCY OUTCOME
Darko Husar
; Privatna ginekološka ordinacija Darko Husar, Zagreb
Josip Đelmiš
; za ženske bolesti i porode Kliničkog bolničkog centra i Medicinskog fakulteta Sveučilišta u Zagrebu
Abstract
There is growing evidence implicating congenital and acquired thrombophilias in the pathophsysiological processes underlying miscarriage, intrauterine growth restriction (IUGR) and pre-eclampsia. Pregnancy itself is notably a hypercoagulable state, at least in part, due to the physiological changes in the coagulation and fibrinolytic systems; that has the potential for interaction with an acquired or heritable thrombophilia to cause adverse outcome. Recurrent fetal loss is associated with antiphospholipid antibody syndrome and some inherited thrombophilias such as Factor V Leiden. There have been reports of both heritable and acquired thrombophilias being associated with pre-eclampsia, IUGR and abruption of the placenta. However, these reactions are not consistently reported with hereditary thrombophilias. The presence of thrombophilia might influence the severity of a condition such as pre-eclampsia, rather than cause it. The risk of fetal loss related to antiphospholipid syndrome can be reduced by antithrombotic therapy with heparin and low dose aspirin. Whether this extends to other thrombophilic conditions associated with adverse pregnancy outcome is not clear and further investigations are required. Screening for, and finding a thrombophilic disease in patients with adverse problems such as recurrent miscarriage, intrauterine death, intrauterine growth restriction and pre-eclampsia are not generally advisable for all of them. It is reasonable in selected women with unexpected late or repeated fetal loss after exclusion of other causes.
Keywords
trombophilia; pregnancy loss; preeclampsia; fetal growth retardation; placental abruption
Hrčak ID:
62191
URI
Publication date:
1.9.2008.
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