Inherited and acquired thrombophilias and poor pregnancy outcome: Should we be treating with heparin?

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dc.contributor.authorGebhardt G.S.
dc.contributor.authorHall D.R.
dc.contributor.authorGebhardt G.S.
dc.contributor.authorHall D.R.
dc.date.accessioned2011-05-15T16:16:12Z
dc.date.accessioned2011-05-15T16:16:12Z
dc.date.available2011-05-15T16:16:12Z
dc.date.available2011-05-15T16:16:12Z
dc.date.issued2003
dc.date.issued2003
dc.description.abstractPurpose of review: The most important acquired thrombophilia related to poor pregnancy outcome is probably antiphospholipid syndrome. Inherited thrombophilias that have been implicated in venous thromboembolism and poor pregnancy outcome and for which standard tests are generally available are antithrombin III deficiency, the factor V Leiden mutation, prothrombin G20210A mutation and the C677T polymorphism in the methylenetetrahydrofolate reductase system implicated in mild hyperhomocysteinaemia. The management of antiphospholipid syndrome with previous fetal losses is well documented and substantiated by small clinical trials. It is the purpose of this review to investigate new contributions to this field since June 2002. Recent findings: Only one randomized trial was published during the review period, but a Cochrane review and several excellent review articles appeared detailing management. Summary: There is a dire lack of randomized trials in the literature on the efficacy of heparin or other coagulation modulators on pregnancy outcome in patients with inherited thrombophilias. There is consensus on thrombo-prophylaxis for antiphospholipid syndrome. Protocols for the management of venous thromboembolism and pulmonary emboli related to pregnancy are well established. © 2003 Lippincott Williams & Wilkins.
dc.description.abstractPurpose of review: The most important acquired thrombophilia related to poor pregnancy outcome is probably antiphospholipid syndrome. Inherited thrombophilias that have been implicated in venous thromboembolism and poor pregnancy outcome and for which standard tests are generally available are antithrombin III deficiency, the factor V Leiden mutation, prothrombin G20210A mutation and the C677T polymorphism in the methylenetetrahydrofolate reductase system implicated in mild hyperhomocysteinaemia. The management of antiphospholipid syndrome with previous fetal losses is well documented and substantiated by small clinical trials. It is the purpose of this review to investigate new contributions to this field since June 2002. Recent findings: Only one randomized trial was published during the review period, but a Cochrane review and several excellent review articles appeared detailing management. Summary: There is a dire lack of randomized trials in the literature on the efficacy of heparin or other coagulation modulators on pregnancy outcome in patients with inherited thrombophilias. There is consensus on thrombo-prophylaxis for antiphospholipid syndrome. Protocols for the management of venous thromboembolism and pulmonary emboli related to pregnancy are well established. © 2003 Lippincott Williams & Wilkins.
dc.description.versionReview
dc.description.versionReview
dc.identifier.citationCurrent Opinion in Obstetrics and Gynecology
dc.identifier.citation15
dc.identifier.citation6
dc.identifier.citationCurrent Opinion in Obstetrics and Gynecology
dc.identifier.citation15
dc.identifier.citation6
dc.identifier.issn1040872X
dc.identifier.issn1040872X
dc.identifier.other10.1097/00001703-200312000-00008
dc.identifier.other10.1097/00001703-200312000-00008
dc.identifier.urihttp://hdl.handle.net/10019.1/13677
dc.identifier.urihttp://hdl.handle.net/10019.1/13677
dc.subjectacetylsalicylic acid; anticoagulant agent; antithrombin III; blood clotting factor 5 Leiden; cardiolipin antibody; heparin; homocysteine; immunoglobulin G; low molecular weight heparin; lupus anticoagulant; phospholipid antibody; protein C; protein S; prothrombin; amino acid metabolism; anticoagulant therapy; anticoagulation; antiphospholipid syndrome; antithrombin III deficiency; clinical trial; controlled clinical trial; disease association; drug dose regimen; drug efficacy; drug indication; gene mutation; genetic disorder; human; hyperhomocysteinemia; immunoglobulin blood level; intrauterine growth retardation; low drug dose; lung embolism; meta analysis; outcomes research; preeclampsia; pregnancy complication; priority journal; randomized controlled trial; review; risk assessment; risk factor; risk reduction; single nucleotide polymorphism; solutio placentae; thrombophilia; thrombosis prevention; venous thromboembolism; Anticoagulants; Antiphospholipid Syndrome; Female; Heparin; Humans; Pregnancy; Pregnancy Complications, Hematologic; Pregnancy Outcome; Thrombophilia
dc.subjectacetylsalicylic acid
dc.subjectanticoagulant agent
dc.subjectantithrombin III
dc.subjectblood clotting factor 5 Leiden
dc.subjectcardiolipin antibody
dc.subjectheparin
dc.subjecthomocysteine
dc.subjectimmunoglobulin G
dc.subjectlow molecular weight heparin
dc.subjectlupus anticoagulant
dc.subjectphospholipid antibody
dc.subjectprotein C
dc.subjectprotein S
dc.subjectprothrombin
dc.subjectamino acid metabolism
dc.subjectanticoagulant therapy
dc.subjectanticoagulation
dc.subjectantiphospholipid syndrome
dc.subjectantithrombin III deficiency
dc.subjectclinical trial
dc.subjectcontrolled clinical trial
dc.subjectdisease association
dc.subjectdrug dose regimen
dc.subjectdrug efficacy
dc.subjectdrug indication
dc.subjectgene mutation
dc.subjectgenetic disorder
dc.subjecthuman
dc.subjecthyperhomocysteinemia
dc.subjectimmunoglobulin blood level
dc.subjectintrauterine growth retardation
dc.subjectlow drug dose
dc.subjectlung embolism
dc.subjectmeta analysis
dc.subjectoutcomes research
dc.subjectpreeclampsia
dc.subjectpregnancy complication
dc.subjectpriority journal
dc.subjectrandomized controlled trial
dc.subjectreview
dc.subjectrisk assessment
dc.subjectrisk factor
dc.subjectrisk reduction
dc.subjectsingle nucleotide polymorphism
dc.subjectsolutio placentae
dc.subjectthrombophilia
dc.subjectthrombosis prevention
dc.subjectvenous thromboembolism
dc.subjectAnticoagulants
dc.subjectAntiphospholipid Syndrome
dc.subjectFemale
dc.subjectHeparin
dc.subjectHumans
dc.subjectPregnancy
dc.subjectPregnancy Complications, Hematologic
dc.subjectPregnancy Outcome
dc.subjectThrombophilia
dc.titleInherited and acquired thrombophilias and poor pregnancy outcome: Should we be treating with heparin?
dc.titleInherited and acquired thrombophilias and poor pregnancy outcome: Should we be treating with heparin?
dc.typeReview
dc.typeReview
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