| Thrombophilia and pregnancy complications: cause or association? | |
| | |
MedLine Citation:
|
PMID: 17635737 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Both acquired and inherited thrombophilia is associated with an increased risk of pregnancy failure (i.e. sporadic and recurrent miscarriage, late fetal loss), as well as hypertensive pregnancy complications such as pre-eclampsia and HELLP syndrome. The question of whether this relationship can be considered causal is rather philosophical. For practical purposes, the consistency and strengths of associations, potential mechanisms and, most importantly, the possibility to intervene with anticoagulants are reviewed. Relevant methodological issues in the case of thrombophilia and pregnancy complications consist of differences between observational and experimental research and quality issues in randomized controlled trials. The mechanisms associating thrombophilia and pregnancy complications are likely to involve effects on trophoblast differentiation rather than mere hypercoagulability. Therapeutic options comprise aspirin as well as (low molecular weight) heparin. For women with antiphospholipid antibody syndrome, this treatment is often suggested although the evidence is limited. For women with inherited thrombophilia and unexplained recurrent pregnancy loss, at present there is no evidence supporting treatment. Observational research is hampered by severe methodological flaws or inconsistent results. Two published randomized trials have not used an adequate comparator (i.e. no treatment or placebo). Currently, randomized controlled trials with no treatment or placebo are being carried out and results should be awaited before implementing a potentially harmful intervention in pregnant women with inherited thrombophilia and a history of pregnancy complications. |
| | |
Authors:
|
S Middeldorp |
Related Documents
:
|
6666557 - Deep vein thrombosis during pregnancy. a prospective study. 22878907 - Could maternal pre-pregnancy body mass index affect apgar score? 22518187 - Maternal music exposure during pregnancy influences neonatal behaviour: an open-label r... 22381037 - Acute antepartum pyelonephritis in pregnancy: a critical analysis of risk factors and o... 2751957 - The excretion of 5-oxoproline in urine, as an index of glycine status, during normal pr... 17706337 - Adhesion molecules changes at 20 gestation weeks in pregnancies complicated by preeclam... |
Publication Detail:
|
Type: Journal Article; Review |
Journal Detail:
|
Title: Journal of thrombosis and haemostasis : JTH Volume: 5 Suppl 1 ISSN: 1538-7933 ISO Abbreviation: J. Thromb. Haemost. Publication Date: 2007 Jul |
Date Detail:
|
Created Date: 2007-07-19 Completed Date: 2007-09-18 Revised Date: 2007-10-01 |
Medline Journal Info:
|
Nlm Unique ID: 101170508 Medline TA: J Thromb Haemost Country: England |
Other Details:
|
Languages: eng Pagination: 276-82 Citation Subset: IM |
Affiliation:
|
Department of Clinical Epidemiology, C9-P, and Vascular Medicine Unit, Department of Endocrinology and General Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands. s.middeldorp@lumc.nl |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Anticoagulants
/
therapeutic use Female Humans Pregnancy Pregnancy Complications, Hematologic* / drug therapy Thrombophilia / complications*, drug therapy, etiology |
| Chemical | |
Reg. No./Substance:
|
0/Anticoagulants |
| Comments/Corrections | |
Erratum In:
|
J Thromb Haemost. 2007 Sep;5(9):1995 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Venous thromboembolism and atherosclerosis: is there a link?
Next Document: Vascular bed-specific thrombosis.