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Thrombophilia in pregnancy

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https://www.readbyqxmd.com/read/28800668/-epidemiology-risk-factors-and-risk-stratification-of-venous-thromboembolism-in-pregnancy-and-the-puerperium
#1
Panagiotis Tsikouras, Georg-Friedrich von Tempelhoff, Werner Rath
Venous thromboembolism (VTE) remains a leading cause of direct maternal deaths in the developed countries. The incidence of VTE has increased significantly during the past two decades. The absolute risk of VTE is estimated 0.6-2.2 per 1000 deliveries. Compared with age-matched non-pregnant women, the daily risk of VTE is increased 7- to 10-fold for antepartum VTE, but it is 15- to 35-fold for postpartum VTE. The incidence of pulmonary embolism (PE) during the first 6 weeks postpartum is nearly 15-fold higher compared to the incidence in pregnancy, and remains significantly increased up to 12 weeks postpartum...
August 2017: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/28796996/call-for-caution-neonatal-portal-vein-thrombosis-following-enbucrilate-embolization-of-placental-chorioangioma
#2
Hian Yan Voon, Rafaie Amin, Juan Loong Kok, Kia Sing Tan
We illustrate a case of giant placental chorioangioma presenting at 20 weeks of gestation. Subsequent monitoring revealed enlargement of the lesion, associated with fetal anemia and cardiac failure, prompting in utero intervention. Amnioreduction followed by percutaneous embolization of the tumour with enbucrilate:Lipiodol Ultra-Fluid™ at a dilution of 1:5 was successfully performed. No repeat intervention or additional supportive measures were required throughout pregnancy and the baby was delivered at 36 weeks of gestation, following spontaneous labour...
August 11, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28792912/adverse-pregnancy-outcomes-and-inherited-thrombophilia
#3
Dominik Dłuski, Radzisław Mierzyński, Elżbieta Poniedziałek-Czajkowska, Bożena Leszczyńska-Gorzelak
AIM: (1) To evaluate the prevalence of inherited thrombophilia in pregnant women with adverse pregnancy outcomes: intrauterine growth retardation (IUGR), preeclampsia (PE) and placental abruption. (2) To assess the impact of inherited thrombophilia on the nature of obstetric complications. (3) To assess levels of protein S, protein C, antithrombin III and homocysteine in pregnant women with adverse pregnancy outcomes. SUBJECTS AND METHODS: The study comprised 162 pregnant women...
August 9, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28769114/diagnosing-antiphospholipid-syndrome-extra-criteria-manifestations-and-technical-advances
#4
REVIEW
Savino Sciascia, Mary-Carmen Amigo, Dario Roccatello, Munther Khamashta
First described in the early 1980s, antiphospholipid syndrome (APS) is a unique form of acquired autoimmune thrombophilia in which patients present with clinical features of recurrent thrombosis and pregnancy morbidity and persistently test positive for the presence of antiphospholipid antibodies (aPL). At least one clinical (vascular thrombosis or pregnancy morbidity) and one lab-based (positive test result for lupus anticoagulant, anticardiolipin antibodies and/or anti-β2-glycoprotein 1 antibodies) criterion have to be met for a patient to be classified as having APS...
August 3, 2017: Nature Reviews. Rheumatology
https://www.readbyqxmd.com/read/28756129/outcomes-of-threatened-abortions-after-anticoagulation-treatment-to-prevent-recurrent-pregnancy-loss
#5
Amihai Rottenstreich, Hagai Amsalem, Geffen Kleinstern, Yosef Kalish
We aimed to determine the outcome of threatened abortion in women treated with low-molecular weight heparin (LMWH) for recurrent pregnancy loss (RPL). Data of women with RPL who experienced threatened abortion while taking LMWH between 2007 and 2016 were retrospectively reviewed. All patients received the LMWH, enoxaparin (40 mg). Thrombophilia was present in 38 (33.3%) women, including 11 (9.6%) with antiphospholipid syndrome (APLS). The overall live birth rate was 58.8% (67/114). Live birth rates were 87...
July 3, 2017: Reproductive Biomedicine Online
https://www.readbyqxmd.com/read/28742523/pregnancy-outcomes-among-patients-with-recurrent-pregnancy-loss-and-uterine-anatomic-abnormalities
#6
Daniel Gabbai, Avi Harlev, Michael Friger, Naama Steiner, Ruslan Sergienko, Andrey Kreinin, Asher Bashiri
BACKGROUND: Different etiologies for recurrent pregnancy loss have been identified, among them are: anatomical, endocrine, genetic, chromosomal and thrombophilia pathologies. AIMS: To assess medical and obstetric characteristics, and pregnancy outcomes, among women with uterine abnormalities and recurrent pregnancy loss (RPL). This study also aims to assess the impact of uterine anatomic surgical correction on pregnancy outcomes. METHODS: A retrospective case control study of 313 patients with two or more consecutive pregnancy losses followed by a subsequent (index) pregnancy...
July 25, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28694860/postpartum-aortic-bifurcation-thrombosis-on-the-background-of-thrombophilic-disorder
#7
Roxana Elena Bohîltea, Natalia Turcan, Horia Muresian, Silvia Condu, Elvira Bratila, Monica Mihaela Cîrstoiu
Two main causes of arterial thrombosis are known: fi rst - atherosclerosis, extensively studied, and the second - atrial fi brillation. The lack of any risk factors and the occurrence at young age of a thrombotic event requires us to investigate possible other conditions, including inherited thrombophilia that is represented by a series of genetic disorders that increase the risk of thromboembolic disease. The role of thrombophilia in the occurrence of arterial thrombosis is inconsequential; this disorder is characterized by the tendency of developing venous thrombosis...
September 2016: Mædica
https://www.readbyqxmd.com/read/28689083/management-of-hereditary-antithrombin-deficiency-in-pregnancy
#8
Andra H James, Shannon M Bates, Kenneth A Bauer, Ware Branch, Kenneth Mann, Michael Paidas, Neil Silverman, Barbara A Konkle
Antithrombin (AT) deficiency is a high-risk thrombophilia and a rare condition. Despite full anticoagulation during pregnancy and the postpartum period, women with AT deficiency may still be vulnerable to developing venous thromboembolism (VTE), including fatal events. There is limited guidance on the management of AT deficiency in pregnancy, including the role of AT concentrates. Following a comprehensive review of the state of the art with respect to recommendations and guidelines, our expert panel in maternal-fetal medicine, hematology and basic science reached consensus on key issues in the recognition and management of AT deficiency in pregnancy...
May 24, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28680464/-to-test-or-not-to-test-the-arguments-for-and-against-thrombophilia-testing-in-obstetrics
#9
REVIEW
Laura Ormesher, Louise E Simcox, Clare Tower, Ian A Greer
Clinicians increasingly investigate women for thrombophilias due to their associations with venous thromboembolism and placenta-mediated pregnancy complication. These associations, however, are modest and based largely on retrospective data from studies with heterogeneous classifications and populations, leading to discordance between evidence and guidelines. Current evidence suggests a contributory rather than causative role for thrombophilia in placenta-mediated pregnancy complication and venous thromboembolism...
June 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28670948/double-versus-single-thrombophilias-during-pregnancy
#10
Rachel Carroll, Andrei Rebarber, Whitney Booker, Nathan Fox, Daniel Saltzman, Jennifer Lam-Rachlin, Simi Gupta
OBJECTIVE: The primary objective of this study was to evaluate whether women with double thrombophilias have a greater risk for obstetric complications as compared with women who have single thrombophilias. STUDY DESIGN: This is a retrospective cohort study of all patients in a single practice with a clinically significant inherited thrombophilia and treated with anticoagulation between 2005 and 2013. Thrombophilias evaluated include: factor V Leiden, prothrombin G20210A gene mutation, protein S deficiency, protein C deficiency, and antithrombin III deficiency...
July 2, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28621046/impact-of-borderline-subclinical-hypothyroidism-on-subsequent-pregnancy-outcome-in-women-with-unexplained-recurrent-pregnancy-loss
#11
Sayaka Uchida, Tetsuo Maruyama, Maki Kagami, Fumie Miki, Hanako Hihara, Satomi Katakura, Yushi Yoshimasa, Hirotaka Masuda, Hiroshi Uchida, Mamoru Tanaka
AIM: Because subclinical hypothyroidism (thyroid-stimulating hormone [TSH] > 4.5 IU/mL) is associated with adverse pregnancy outcome, including early pregnancy loss, TSH is recommended to be titrated to ≤2.5 mIU/L in levothyroxine-treated women before pregnancy. The purpose of this study was to determine whether borderline-subclinical hypothyroidism (borderline-SCH; 2.5 < TSH ≤ 4.5 IU/mL) affects the outcome of subsequent pregnancies in women with unexplained recurrent pregnancy loss (uRPL)...
June 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28605659/trimester-specific-coagulation-and-anticoagulation-reference-intervals-for-healthy-pregnancy
#12
Chanjuan Cui, Shuo Yang, Jie Zhang, Guojing Wang, Shengkai Huang, Aiwei Li, Yuncong Zhang, Rui Qiao
BACKGROUND: Due to the normal physiological need of pregnancy and childbirth, the haemostatic system of pregnant women is different from that of healthy non-pregnant women. The aim of this study was to establish trimester-specific reference intervals of coagulation screening tests and thrombophilia markers in pregnancies without complications of females with Han ethnicity from North China. METHODS: In total 744 Han healthy pregnant women (first trimester 207 cases, second trimester 222 cases and third trimester 315 cases) and 121 healthy non-pregnant women were recruited in North China...
May 24, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28589438/obstetrical-history-of-women-with-cerebral-vein-thrombosis-outcome-of-the-pregnancies-before-and-after-the-thrombotic-event
#13
Daniela Poli, Caterina Cenci, Sophie Testa, Oriana Paoletti, Elena Silvestri, Emilia Antonucci
Cerebral vein thrombosis (CVT) is a rare disease usually affecting young people, especially women, with a high prevalence of thrombophilic defects. It is known that thrombophilia is associated with pregnancy complications; therefore, a high rate of complications could be expected in women with the previous CVT who become pregnant. This study examined the whole obstetric history of women who suffered from CVT to evaluate the incidence of pregnancy complications during their entire lifespan. We prospectively followed consecutive patients with CVT, limiting the analysis to females and their obstetrical history...
June 6, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28578513/the-role-of-fv-1691g-a-fii-20210g-a-mutations-and-mthfr-677c-t-1298a-c-and-103g-t-fxiii-gene-polymorphisms-in-pathogenesis-of-intraventricular-hemorrhage-in-infants-born-before-32-weeks-of-gestation
#14
Dawid Szpecht, Janusz Gadzinowski, Agnieszka Seremak-Mrozikiewicz, Grażyna Kurzawińska, Krzysztof Drews, Marta Szymankiewicz
BACKGROUND: Congenital thrombophilia is associated with an increased intraventricular hemorrhage (IVH) risk among newborns, but it may also play a protective role. The role of genetic polymorphisms involved in the coagulation pathway of IVH pathogenesis is probably a consequence of an increased risk of thrombosis in the fine blood vessels in the germinal matrix region. MATERIAL AND METHODS: The aim of this study was to evaluate the possible relationship between Factor V (FV) 1691G>A, Factor II (FII) 20210G>A mutations and methylenetetrahydrofolate reductase (MTHFR) 677C>T; 1298A>C and Factor XIII (FXIII) 103G>T gene polymorphisms and the occurrence of IVH in 100 infants born from 24 + 0 to 32 + 0 weeks of gestation, born from singleton pregnancy, before 32 + 0 weeks of gestation, exposed to antenatal steroid therapy, and without congenital abnormalities...
July 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28578446/unilateral-adrenal-infarction-in-pregnancy-secondary-to-elevated-factor-viii
#15
Khaled Y Aljenaee, Sulaiman A Ali, Seong K Cheah, Moudhi J Alroomi
Adrenal infarction in pregnancy is an extremely rare event. We report a case of a 29-year-old pregnant woman at the twenty-fourth week of gestation that presented with an acute episode of severe localized right upper quadrant pain. Her preliminary blood investigations and abdominal ultrasonography were essentially unremarkable. A diagnosis of right adrenal infarction was subsequently established on the basis of a non-enhanced swollen right adrenal gland on CT scanning of the abdomen with contrast, consistent with the clinical presentation...
June 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28553146/recurrent-pregnancy-loss-current-perspectives
#16
REVIEW
Hady El Hachem, Vincent Crepaux, Pascale May-Panloup, Philippe Descamps, Guillaume Legendre, Pierre-Emmanuel Bouet
Recurrent pregnancy loss is an important reproductive health issue, affecting 2%-5% of couples. Common established causes include uterine anomalies, antiphospholipid syndrome, hormonal and metabolic disorders, and cytogenetic abnormalities. Other etiologies have been proposed but are still considered controversial, such as chronic endometritis, inherited thrombophilias, luteal phase deficiency, and high sperm DNA fragmentation levels. Over the years, evidence-based treatments such as surgical correction of uterine anomalies or aspirin and heparin for antiphospholipid syndrome have improved the outcomes for couples with recurrent pregnancy loss...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28544373/genetic-markers-for-inherited-thrombophilia-are-associated-with-fetal-growth-retardation-in-the-population-of-central-russia
#17
Evgeny Reshetnikov, Oksana Zarudskaya, Alexey Polonikov, Olga Bushueva, Valentina Orlova, Evgeny Krikun, Volodymyr Dvornyk, Mikhail Churnosov
AIM: The aim of this study was to examine the role of hereditary thrombophilia in the development of fetal growth retardation (FGR) in the population of Central Russia. METHODS: The case-control study sample included 497 women in the third trimester of pregnancy recruited during 2009-2013. The participants were enrolled into two groups: patients with FGR (n = 250) and controls without FGR (n = 247). The participants were genotyped for four genetic markers of hereditary thrombophilia: factor V Leiden (G > A FV, rs6025), prothrombin (G > A FII, rs1799963), factor VII (G > A FVII, rs6046), and fibrinogen (G > A FI, rs1800790)...
May 19, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28532221/antiphospholipid-antibodies-are-associated-with-positive-screening-for-common-mental-disorders-in-women-with-previous-pregnancy-loss-the-noha-psy-observational-study
#18
Jean-Christophe Gris, Fabienne Cyprien, Sylvie Bouvier, Eva Cochery-Nouvellon, Géraldine Lavigne-Lissalde, Erick Mercier, Jean-Pierre Balducchi
OBJECTIVES: Case reports describe neuropsychiatric manifestations associated with antiphospholipid antibodies (aPlAbs). In patients sharing the same symptoms fulfilling the antiphospholipid syndrome (APS) clinical criteria, the prevalence of common mental disorders has, however, never been studied. METHODS: We observed women with three consecutive abortions before the 10th week of gestation or one foetal loss at or beyond the 10th week. We compared the prevalence of common psychiatric disorders detected through screening using the Mini International Neuropsychiatric Interview, 10 years after inclusion, in women with APS (n = 506), women negative for aPlAbs but carrying the F5rs6025 or F2rs1799963 thrombogenic polymorphism (n = 269), and women with negative thrombophilia screening results as controls (n = 764)...
June 19, 2017: World Journal of Biological Psychiatry
https://www.readbyqxmd.com/read/28504829/prediction-of-thrombophilia-in-patients-with-unexplained-recurrent-pregnancy-loss-using-a-statistical-model
#19
Tongfei Wang, Xiaomin Kang, Liying He, Zhilan Liu, Haijing Xu, Aimin Zhao
OBJECTIVE: To establish a statistical model to predict thrombophilia in patients with unexplained recurrent pregnancy loss (URPL). METHODS: A retrospective case-control study was conducted at Ren Ji Hospital, Shanghai, China, from March 2014 to October 2016. The levels of D-dimer (DD), fibrinogen degradation products (FDP), activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen (Fg), and platelet aggregation in response to arachidonic acid (AA) and adenosine diphosphate (ADP) were collected...
May 15, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28494269/medical-conditions-associated-with-recurrent-miscarriage-is-bmi-the-tip-of-the-iceberg
#20
Mushi J Matjila, Anne Hoffman, Zephne M van der Spuy
BACKGROUND: In contrast to sporadic miscarriage, recurrent miscarriage (RM) is a rare entity which affects 1% of couples attempting conception. It is distressing for couples and healthcare professionals as the aetiology is unclear with limited treatment options. Apart from anti-phospholipid syndrome (APS), the strength of associations between RM and commonly investigated endocrine, autoimmune, thrombophilic and uterine structural abnormalities remains uncertain and variable. OBJECTIVES: To assess the prevalence of commonly investigated medical conditions associated with RM...
July 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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