Prothrombin and Factor V Mutations in Women With a History of Thrombosis During Pregnancy and the Puerperium

Gerhardt, Andrea; Scharf, Rüdiger E.; Beckmann, Matthias W.; Struve, Sabine; Pillny, M.; Sandmann, W.; Zotz, Rainer B.

doi:10.1097/00006254-200007000-00002

Cited by 30 publications

(55 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Thrombophilia Thrombophilia (22%) was found less frequently than in previous studies (Gerhardt et al, 2000;McColl et al, 1997McColl et al, , 2000Pabinger et al, 2005) partly because of the fact that FVIII coagulant activity and homocysteine levels were not tested in most centres, and anti-beta2 glycoprotein assays were not considered part of the defining criteria for antiphospholipid antibodies until 2006. Sixteen women with no past history of VTE were identified as having thrombophilia, two having been tested prior to the pregnancy.…”

Section: Previous Vtementioning

confidence: 94%

The management of antenatal venous thromboembolism in the UK and Ireland: a prospective multicentre observational survey*

Voke¹,

Keidan²,

Pavord³

et al. 2007

Br J Haematol

View full text Add to dashboard Cite

Summary This prospective observational study reports on 126 women from 25 UK centres with image‐proven antenatal venous thromboembolism (VTE), 62% deep vein thrombosis and 38% pulmonary embolism. Thrombophilia screening was of limited benefit except to identify antithrombin deficiency. Sixteen (13%) patients had previous VTE, all but one was related to previous pregnancy or combined oral contraceptive and 12 received no thromboprophylaxis in the index pregnancy, the other four thus received inadequate low molecular weight heparin (LMWH) doses. Treatment was with dalteparin in 25%, enoxaparin in 47%, tinzaparin in 25% and unfractionated heparin alone in 3%. 66% of patients received once‐daily LMWH. Anti‐activated factor X (anti‐Xa) monitoring was performed at 90% of centres, with a wide range of target values. Thus current management of antenatal VTE, despite widely diverse clinical practice, appeared effective and safe, for there were no recurrent events and postpartum haemorrhage was not increased when compared to known rates. Larger studies are required to confirm this. The need for twice as opposed to once daily LMWH and for anti‐Xa monitoring is questioned by this study. The importance of clinical risk assessment and adherence to the Royal College of Obstetricians and Gynaecologists guidelines on antenatal thromboprophylaxis, with adequate LMWH dosing is confirmed.

show abstract

Section: Previous Vtementioning

confidence: 94%

The management of antenatal venous thromboembolism in the UK and Ireland: a prospective multicentre observational survey*

Voke¹,

Keidan²,

Pavord³

et al. 2007

Br J Haematol

View full text Add to dashboard Cite

show abstract

“…With the exception of homozygosity for MTHFR C677T, all heritable thrombophilias were found to be significantly associated with an increased risk of VTE (Fig 2). In particular, the OR for VTE among factor V Leiden homozygous carriers during pregnancy was as high as 34AE40 (95% CI 9AE86-120AE05) (Gerhardt et al, 2000;Murphy et al, 2000;Martinelli et al, 2001a;Tormene et al, 2001). The pooled data on MTHFR homozygous cases indicated significant heterogeneity (Fig 2).…”

Section: Vtementioning

confidence: 99%

“…Nine studies (n ¼ 2526) assessed the risk of VTE in pregnant women with heritable thrombophilia (Grandone et al, 1998;Dilley et al, 2000;Gerhardt et al, 2000;Murphy et al, 2000;Pabinger et al, 2000;Martinelli et al, 2001aMartinelli et al, , 2002Tormene et al, 2001;Ogunyemi et al, 2003). With the exception of homozygosity for MTHFR C677T, all heritable thrombophilias were found to be significantly associated with an increased risk of VTE (Fig 2).…”

Section: Vtementioning

confidence: 99%

Thrombophilia in pregnancy: a systematic review

et al. 2005

View full text Add to dashboard Cite

Summary Growing evidence suggests that thrombophilia is associated with venous thromboembolism (VTE) and adverse pregnancy outcomes. However, methodological limitations have made it difficult to obtain a clear overview of the overall risks. We conducted a systematic review to determine the risk of VTE and adverse pregnancy outcomes associated with thrombophilia in pregnancy. The effectiveness of prophylactic interventions during pregnancy was also evaluated. Major electronic databases were searched, relevant data abstracted and study quality assessed by two independent reviewers. Odds ratios (ORs) stratified by thrombophilia type were calculated for each outcome. A total of 79 studies were included in our review. The risks for individual thrombophilic defects were determined for VTE (ORs, 0·74–34·40); early pregnancy loss (ORs, 1·40–6·25); late pregnancy loss (ORs, 1·31–20·09); pre‐eclampsia (ORs, 1·37–3·49); placental abruption (ORs, 1·42–7·71) and intrauterine growth restriction (ORs, 1·24–2·92). Low‐dose aspirin plus heparin was the most effective in preventing pregnancy loss in thrombophilic women (OR, 1·62). Our findings confirm that women with thrombophilia are at risk of developing VTE and complications in pregnancy. However, despite the increase in relative risk, the absolute risk of VTE and adverse outcomes remains low. There is also a lack of controlled trials of antithrombotic intervention to prevent pregnancy complications. Thus, at present, universal screening for thrombophilia in pregnancy cannot be justified clinically.

show abstract

“…Inherited thrombophilia, depending on how it is defined, is present in 20-50 percent of women who experience VTE during pregnancy and the postpartum period (Dilley et al, 2000;Gerhardt et al, 2000;De Stefano et al, 2006). Deficiencies of the natural anticoagulants (antithrombin, protein C, and protein S) are relatively rare, high-risk thrombophilias (relative risk for heterozygotes about 10).…”

Section: Procoagulantsmentioning

confidence: 99%

Thrombosis in pregnancy and maternal outcomes

James

2015

Birth Defects Research Pt C

View full text Add to dashboard Cite

Pregnancy increases the risk of thrombosis four- to five-fold. Seventy-five to eighty percent of pregnancy-related thrombotic events are venous and twenty to -twenty-five percent are arterial. The main reason for the increased risk is hypercoagulability. Women are hypercoagulable because they have evolved so that they are protected against the bleeding challenges of pregnancy, miscarriage, or childbirth. Both genetic and acquired risk factors can further increase the risk of thrombosis. The maternal consequences of thrombosis of pregnancy include permanent vascular damage, disability, and death. While the maternal outcomes of thrombosis can be modified by anticoagulation therapy, management of thrombosis during pregnancy is the subject of another paper in this issue (see paper by B. Konkle). This review will focus on the epidemiology, pathophysiology, risk factors, and maternal consequences of thrombosis in pregnancy.

show abstract

Prothrombin and Factor V Mutations in Women With a History of Thrombosis During Pregnancy and the Puerperium

Cited by 30 publications

References 0 publications

The management of antenatal venous thromboembolism in the UK and Ireland: a prospective multicentre observational survey*

The management of antenatal venous thromboembolism in the UK and Ireland: a prospective multicentre observational survey*

Thrombophilia in pregnancy: a systematic review

Thrombosis in pregnancy and maternal outcomes

Contact Info

Product

Resources

About