Thrombophilia
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In hematology, thrombophilia, also called hypercoagulability, is "a disorder of hemostasis in which there is a tendency for the occurrence of thrombosis."[1]
Clinical
Recurrent embolism and thrombosis
Examples include prothrombin gene G-->A20210 mutation.[2]
Habitual abortion
| Odds ratio | ||
|---|---|---|
| Early pregnancy loss (before 13 weeks) |
Late pregnancy loss | |
| Factor V Leiden | 2.01 (95% CI 1.13-3.58) | 7.83 (95% CI 2.83-21.67) |
| Prothrombin G20210A | 2.56 (95% CI 1.04-.29) | 2.30 (95% CI 1.09-4.87) (non-recurrent) |
| Protein C deficiency | No association | |
| Activated protein C resistance | 3.48 (95% CI 1.58-7.69) | |
| Protein S deficiency | 7.39 (95% CI 1.28-42.63) (nonrecurrent) | |
| Methylenetetrahydrofolate reductase mutation | No association | |
| Antithrombin deficiencies | No association | |
Thrombophilia have an increased risk of fetal loss, especially stillbirth after 28 weeks of gestation as opposed to miscarriage (spontaneous abortion) before 28 weeks of gestation[4]
Habitual abortion, the occurrence of three or more spontaneous abortions may be due to thrombophilia.[3]
The benefit of adding treatment with low molecular weight heparin to patients already taking aspirin is not clear.[5]
References
- ↑ Anonymous (2024), Thrombophilia (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Margaglione M, Brancaccio V, Giuliani N, D'Andrea G, Cappucci G, Iannaccone L et al. (1998). "Increased risk for venous thrombosis in carriers of the prothrombin G-->A20210 gene variant.". Ann Intern Med 129 (2): 89-93. PMID 9669991. [e]
- ↑ 3.0 3.1 Rey E, Kahn SR, David M, Shrier I (2003). "Thrombophilic disorders and fetal loss: a meta-analysis.". Lancet 361 (9361): 901-8. DOI:10.1016/S0140-6736(03)12771-7. PMID 12648968. Research Blogging.
- ↑ Preston FE, Rosendaal FR, Walker ID, Briët E, Berntorp E, Conard J et al. (1996). "Increased fetal loss in women with heritable thrombophilia.". Lancet 348 (9032): 913-6. PMID 8843809.
- ↑ Laskin CA, Spitzer KA, Clark CA, Crowther MR, Ginsberg JS, Hawker GA et al. (2009). "Low molecular weight heparin and aspirin for recurrent pregnancy loss: results from the randomized, controlled HepASA Trial.". J Rheumatol 36 (2): 279-87. DOI:10.3899/jrheum.080763). PMID 19208560. Research Blogging.