Thromboembolism and thrombophilia in pregnancy

Calderwood, Carmelita; Thanoon, Omar

doi:10.1016/j.ogrm.2009.10.001

Cited by 10 publications

(11 citation statements)

References 13 publications

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“…Our findings agree with studies reporting the contribution of various thrombophilic defects to the risk of maternal VTE [1,2,11,12].…”

Section: Discussionsupporting

confidence: 92%

“…Normal pregnancy is accompanied by many changes in the hemostatic system that promote hypercoagulability [1][2][3]. Therefore, all pregnant women are inherently at risk of thrombosis compared with nonpregnant women.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, all pregnant women are inherently at risk of thrombosis compared with nonpregnant women. This risk is manifest from early in the first trimester until at least 6 weeks postpartum [1,3]. Venous thromboembolism (VTE) associated with pregnancy causes marked morbidity and is one of the leading causes of maternal death in Western countries [4].…”

Section: Introductionmentioning

confidence: 99%

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Effects of prothrombotic markers and non-O blood group in maternal venous thromboembolism during pregnancy and postpartum

Klai¹,

Fekih-Mrissa²,

Sassi³

et al. 2012

Blood Coagulation &Amp; Fibrinolysis

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Our aim was to assess thrombophilic risk factors and the non-O blood group as contributors to the development of venous thromboembolism during pregnancy and the postpartum period. A total of 199 women underwent blood typing and an extensive thombophilia screening. Factor V Leiden, FII G20210A, protein C deficiency and non-O blood group were significantly associated with venous thromboembolism during pregnancy and postpartum period. A known thrombophilic factor may have consequences for future pregnancies and could have implications for clinical practice. For this reason, women with a history of thromboembolism should be screened for thrombophilia. The non-O blood group could also have an important influence, especially when concomitant with another prothrombotic risk factor mainly pregnancy and thrombophilia.

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“…Our findings agree with studies reporting the contribution of various thrombophilic defects to the risk of maternal VTE [1,2,11,12].…”

Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of prothrombotic markers and non-O blood group in maternal venous thromboembolism during pregnancy and postpartum

Klai¹,

Fekih-Mrissa²,

Sassi³

et al. 2012

Blood Coagulation &Amp; Fibrinolysis

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“…Women with low platelet counts in pregnancy are generally less symptomatic due to the procoagulant state induced by increased levels of fibrinogen, factor VIII and von Willebrand Factor (VWF), suppressed fibrinolysis and reduced protein S activity (Calderwood, 2006).…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and management of maternal thrombocytopenia in pregnancy

2012

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SummaryThrombocytopenia is a common finding in pregnancy, occurring in approximately 7-10% of pregnancies. It may be a diagnostic and management problem, and has many causes, some of which are specific to pregnancy. Although most cases of thrombocytopenia in pregnancy are mild, and have no adverse outcome for either mother or baby, occasionally a low platelet count may be part of a more complex disorder with significant morbidity and may be life-threatening. Overall, about 75% of cases are due to gestational thrombocytopenia, 15-20% secondary to hypertensive disorders; 3-4% due to an immune process, and the remaining 1-2% made up of rare constitutional thrombocytopenias, infections and malignancies. In this review, a diagnostic approach to investigating thrombocytopenia in pregnancy is presented, together with antenatal, anaesthetic and peri-natal management issues for mother and baby, followed by a detailed discussion on the specific causes of thrombocytopenia and the management options in each case.

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“…138,139 A study of 119 pregnancies in 92 women with ITP found that 31% required intervention. Pregnancy is associated with a procoagulant state in preparation for the hemostatic challenge of delivery 140 due to increased levels of fibrinogen, factor VIII, and von Willebrand factor; suppressed fibrinolysis; and a reduction in the activity of protein S. 140 These changes may result in fewer bleeding symptoms and therefore a greater tolerance to ITP in pregnant compared with non-pregnant women (evidence level IV). …”

Section: Thrombocytopenia In Pregnancy Presentation Of Thrombocytopenmentioning

confidence: 99%

International consensus report on the investigation and management of primary immune thrombocytopenia

Provan¹,

Stasi

Newland³

et al. 2010

Blood

1,849

1,954

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IntroductionPrimary immune thrombocytopenia (ITP) is an acquired immunemediated disorder characterized by isolated thrombocytopenia, defined as a peripheral blood platelet count less than 100 ϫ 10 9 /L, and the absence of any obvious initiating and/or underlying cause of the thrombocytopenia. 1 Until recently, the abbreviation ITP stood for idiopathic thrombocytopenic purpura, but current awareness relating to the immune-mediated nature of the disease, and the absence or minimal signs of bleeding in a large proportion of cases have led to a revision of the terminology. 1 Concepts surrounding the mechanisms of thrombocytopenia in ITP have shifted from the traditional view of increased platelet destruction mediated by autoantibodies to more complex mechanisms in which both impaired platelet production and T cell-mediated effects play a role. [2][3][4][5][6] Recent epidemiologic data suggest that the incidence in adults is approximately equal for the sexes except in the mid-adult years (30-60 years), when the disease is more prevalent in women. 7,8 ITP is classified by duration into newly diagnosed, persistent (3-12 months' duration) and chronic (Ն 12 months' duration). 1 Whereas ITP in adults typically has an insidious onset with no preceding viral or other illness and it normally follows a chronic course, 9 ITP in children is usually short-lived with at least two-thirds recovering spontaneously within 6 months. 10 Signs and symptoms vary widely. Many patients have either no symptoms or minimal bruising, whereas others experience serious bleeding, which may include gastrointestinal hemorrhage (GI), extensive skin and mucosal hemorrhage, or intracranial hemorrhage (ICH). The severity of thrombocytopenia correlates to some extent but not completely with the bleeding risk. 7,11 Additional factors (eg, age, lifestyle factors, uremia) affect the risk and should be evaluated before the appropriate management is determined.The investigation and management of ITP patients vary widely. The purpose of this consensus document is to comment on new data and provide recommendations relating to diagnosis and treatment. Final judgment regarding care of individual patients should, however, lie with the responsible health care professional and be based on careful investigation of individual circumstances. MethodsComposition of the panel. The panel included 22 members with recognized clinical and research expertise in ITP representing North America (United States, 7; Canada, 1), Europe (France, 1; Italy, 2; Spain, 1; Switzerland, 1; United Kingdom, 8), and Australia (1).Assessment of the literature. Articles were identified by a computer-assisted search of the literature published in English using the National Library of Medicine PubMed database. The For personal use only. on May 7, 2018. by guest www.bloodjournal.org From search criteria were: 'immune thrombocytopenic purpura', 'idiopathic thrombocytopenic purpura', 'ITP', and 'autoimmune thrombocytopenic purpura'. A subsequent search was performed using the corresponding MedLin...

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Thromboembolism and thrombophilia in pregnancy

Cited by 10 publications

References 13 publications

Effects of prothrombotic markers and non-O blood group in maternal venous thromboembolism during pregnancy and postpartum

Effects of prothrombotic markers and non-O blood group in maternal venous thromboembolism during pregnancy and postpartum

Diagnosis and management of maternal thrombocytopenia in pregnancy

International consensus report on the investigation and management of primary immune thrombocytopenia

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