15. Inherited and Acquired Thrombophilias
- John T. Queenan MD1,
- Catherine Y. Spong MD2,
- Charles J. Lockwood MD3
Published Online: 4 JAN 2012
DOI: 10.1002/9781119963783.ch15
Copyright © 2012 John Wiley and Sons, Ltd
Book Title
Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition
Additional Information
How to Cite
Paidas, M. J. (2012) Inherited and Acquired Thrombophilias, in Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition (eds J. T. Queenan, C. Y. Spong and C. J. Lockwood), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781119963783.ch15
Editor Information
- 1
Department of Obstetrics and Gynecology, Georgetown University School of Medicine, Washington, DC, USA
- 2
Bethesda, MD, USA
- 3
Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA
Publication History
- Published Online: 4 JAN 2012
- Published Print: 24 FEB 2012
ISBN Information
Print ISBN: 9780470655764
Online ISBN: 9781119963783
- Summary
- Chapter
- References
Keywords:
- inherited and acquired thrombophilias;
- predominant thrombophilic mutations;
- FVL mutation, and PGM;
- hemostatic changes in pregnancy;
- changes in natural anticoagulant, fibrinolytic systems;
- hemostatic changes in pregnancy;
- inherited thrombophilias, and venous thromboembolism;
- abruptio placentae, and thrombophilia and abruption, challenging;
- antithrombin deficiency;
- screening, inherited and acquired thrombophilia
Summary
Thrombophilias present an evolving, controversial story. Predominant thrombophilic mutations include the factor V Leiden mutation, prothrombin G20210A gene mutation, and deficiencies of the natural anticoagulants proteins C and S, and antithrombin. Prospective cohort studies have provided an accurate assessment of the risk for placenta-mediated complications posed by common inherited thrombophilic conditions. Acquired thrombophilic conditions consist of the antiphospholipid antibody syndrome and hyperhomocysteinemia. Well-conducted, placebo-controlled, randomized trials have demonstrated no benefit of anticoagulation in women with recurrent pregnancy loss and inherited thrombophilia. The routine use of anticoagulation to prevent other placenta-mediated complications in the setting of inherited thrombophilia should be considered experimental until the results of adequate clinical trials are available. Heparin and antiplatelet therapy are the cornerstones of treatment of antiphospholipid antibody syndrome in pregnancy.