Approach to Thrombophilia in Pregnancy—A Narrative Review

Abstract

Thrombophilia is a genetic predisposition to hypercoagulable states caused by acquired haemostasis conditions; pregnancy causes the haemostatic system to become hypercoagulable, which grows throughout the pregnancy and peaks around delivery. Genetic testing for thrombophilic gene mutations is evaluated using different methodologies of real-time polymerase chain reaction and DNA microarrays of specific genes. Adapting the general care of the pregnant woman to the particularities caused by thrombophilia is an important component, so screening is preferred to assess the degree of genetic damage that manifests itself as a risk of thrombosis. The major goal of this narrative review was to quantitatively evaluate the literature data on the specific care of pregnant women with thrombophilia that are at risk of developing unplanned miscarriages.

Assessment of the Particularities of Thrombophilia in the Management of Pregnant Women in the Western Part of Romania

“…Thrombophilias can be categorized as either acquired or inherited [ 1 ]. Mixed thrombophilia is a condition that can result from both hereditary and nongenetic sources.…”

“…The hemostatic system changes during pregnancy to become hypercoagulable, which raises the risk of thrombosis throughout pregnancy and reaches its peak at term [ 5 ]. One of the risk factors among reproductive diseases is represented by hereditary thrombophilia [ 1 ].…”

“…The diagnosis is based on the Sydney criteria, which include one clinical criterion (pregnancy morbidity or serious or venous thrombosis) and one laboratory criterion (detection of abnormally high levels of high levels of IgM/IgG anticardiolipin antibodies, of anti-beta 2 glycoprotein-I antibodies, or of lupus anticoagulant). This is also linked to obstetric difficulties [ 1 ]. There are two categories of inheritable thrombophilic states, classified by Pinjala et al, namely, major or common inherited thrombophilias [ 6 ].…”

“…One identified pathogenic factor causing severe pregnancy problems is thrombophilia. Procoagulant factors that have undergone modifications—mutant genes with a high prevalence that raise the risk of developing thrombosis—have been researched [ 1 , 8 , 9 ]: MTHFR homozygous or heterozygous mutation in the C677T and A1298C positions, FVL gene homozygous or heterozygous mutation in the G1691A position, prothrombin gene homozygous or heterozygous mutation in the G20210A position, or the polymorphism of PAI-1 [ 1 ]. The hemostasis undergoes major alterations throughout a normal pregnancy, which favors procoagulants.…”

Роль Тромбофилии И Полиморфизма Ферментов Фолатного Цикла В Диагностике Потерь Беременности

“…Многочисленные исследования свидетельствуют о том, что беременные женщины с тромбофилиями относятся к группе риска по репродуктивным потерям [7,8]. Для запуска процесса тромбообразования чаще всего сама беременность является провоцирующим фактором.…”