Document Detail


[Hereditary thrombophilias and placental-mediated pregnancy complications in the II./III. trimester].
MedLine Citation:
PMID:  23392307     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Placental-mediated pregnancy complications (PmC) like preeclampsia, intrauterine growth restriction and placental abruption are common causes of fetal and maternal morbidity and mortality. The high prevalence of hereditary thrombophilias in case-control studies associated with pathological morphological findings of the placenta in these cases gave evidence for the association between hereditary thrombophilias and PmC. However, data from the literature are inconsistent, since subsequent prospective cohort studies could not demonstrate significant associations between inherited thrombophilia and PmC. Because of the multifactorial aetiology of PmC it may be difficult to prove, that hereditary thrombophilias are independent risk factors for PmC.Current guidelines do not recommend screening for inherited thrombophilias in patients with previous PmC. Evidence from current in vitro studies have shown, that heparin has beneficial non-anticoagulatory effects on trophoblast invasion. Retrospective case-control studies and recently published randomised controlled cohort studies have shown, that prophylactic administration of low-molecular-weight heparin (LWH), started in early pregnancy, may lead to a significant reduction in the incidence of PmC in subsequent pregnancies in patients with and without hereditary thrombophilias and previous PmC. Conclusion: Large, well-designed multicenter studies are needed to elucidate the role of hereditary thrombophilias in cases of PmC and to confirm the benefit of LWH for subsequent pregnancy outcomes.
Authors:
W Rath; C J Thaler
Publication Detail:
Type:  English Abstract; Journal Article    
Journal Detail:
Title:  Hämostaseologie     Volume:  33     ISSN:  0720-9355     ISO Abbreviation:  Hamostaseologie     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-02-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8204531     Medline TA:  Hamostaseologie     Country:  Germany    
Other Details:
Languages:  ger     Pagination:  21-36     Citation Subset:  IM    
Affiliation:
Univ.- Prof. Dr. med. Werner Rath, Gynäkologie und Geburtshilfe, Medizinische Fakultät, Universitätsklinikum, Wendlingweg 2, 52074 Aachen, Tel. 02 41/808 08 84, Fax 02 41/808 27 11, E-Mail: wrath@ukaachen.de.
Vernacular Title:
Hereditäre Thrombophilien und Plazenta-medierte Schwangerschaftskomplikationen im II./III. Trimenon.
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