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Thrombophilia in pregnancy

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https://www.readbyqxmd.com/read/27913455/inherited-thrombophilia-a-double-edged-sword
#1
Saskia Middeldorp
Inherited thrombophilia is a blood coagulation disorder that increases the risk for venous thromboembolism (VTE). During the last decades, the practice of testing has evolved from testing selected populations, leading to high perceived risks, to broad testing for various conditions that included VTE, arterial thrombosis, and pregnancy complications. Because results of such tests usually do not guide treatment decisions, not testing patients with VTE for inherited thrombophilia is on the "Choosing Wisely" list endorsed by multiple specialty societies, including ASH...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27892779/causes-of-stillbirth-in-a-socio-economically-disadvantaged-urban-australian-population-a-comprehensive-analysis
#2
L A Wijs, E C de Graaff, S Leemaqz, G A Dekker
INTRODUCTION: The aim of this paper was to provide an in depth analysis of all stillbirth causation over a period of 10 years in a busy maternity unit located in a socio-economically disadvantaged urban area, with an emphasis on overlapping pathology. MATERIALS AND METHODS: A retrospective analysis of all structurally normal stillbirths in singleton pregnancies born 2002-2012. The PSANZ stillbirth classification was used; per stillbirth subgroup main risk factors were evaluated...
November 28, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27876004/enoxaparin-for-the-prevention-of-preeclampsia-and-intrauterine-growth-restriction-in-women-with-a-prior-history-an-open-label-randomised-trial-the-eppi-trial-study-protocol
#3
K M Groom, L M McCowan, P R Stone, L C Chamley, C McLintock
BACKGROUND: Preeclampsia and intrauterine fetal growth restriction (IUGR) are two of the most common causes of maternal and perinatal morbidity and mortality. Current methods of predicting those at most risk of these conditions remain relatively poor, and in clinical practice past obstetric history remains the most commonly used tool. Aspirin and, in women at risk of preeclampsia only, calcium have been demonstrated to have a modest effect on risk reduction. Several observational studies and randomised trials suggest that low molecular weight heparin (LMWH) therapy may confer some benefit...
November 22, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27815482/mutations-of-two-major-coagulation-factors-are-not-associated-with-male-infertility
#4
Christos Yapijakis, Nikos Pachis, Dimitris Avgoustidis, Mary Adamopoulou, Zoe Serefoglou
BACKGROUND: Thrombophilia-related mutations, such as coagulation factor V Leiden and factor II (G20210A), have been associated with female infertility due to spontaneous abortions during pregnancy. The possible role of mutations of these two factors in male infertility has not been studied to date. MATERIALS AND METHODS: A total of 208 unrelated Greek men were investigated, including 108 infertile men with idiopathic oligozoospermia, azoospermia, and oligozoospermia of various etiologies, as well as 100 fertile male controls...
November 2016: In Vivo
https://www.readbyqxmd.com/read/27799851/low-molecular-weight-heparin-can-benefit-women-with-recurrent-pregnancy-loss-and-sole-protein-s-deficiency-a-historical-control-cohort-study-from-taiwan
#5
Ming-Ching Shen, Wan-Ju Wu, Po-Jen Cheng, Gwo-Chin Ma, Wen-Chu Li, Jui-Der Liou, Cheng-Shyong Chang, Wen-Hsiang Lin, Ming Chen
BACKGROUND: Heritable thrombophilias are assumed important etiologies for recurrent pregnancy loss. Unlike in the Caucasian populations, protein S and protein C deficiencies, instead of Factor V Lieden and Prothrombin mutations, are relatively common in the Han Chinese population. In this study we aimed to investigate the therapeutic effect of low molecular weight heparin upon women with recurrent pregnancy loss and documented protein S deficiency. METHODS: During 2011-2016, 68 women with recurrent pregnancy loss (RPL) and protein S deficiency (both the free antigen and function of protein S were reduced) were initially enrolled...
2016: Thrombosis Journal
https://www.readbyqxmd.com/read/27799457/the-prevalence-of-thrombophilia-in-women-with-recurrent-fetal-loss-and-outcome-of-anticoagulation-therapy-for-the-prevention-of-miscarriages
#6
Rawan Nahas, Walid Saliba, Adi Elias, Mazen Elias
OBJECTIVE: To estimate the prevalence of thrombophilia in women with recurrent miscarriages and to assess the effect of antithrombotic therapy. DESIGN: A retrospective cohort study between the years 2004 and 2010. SETTING: A hypercoagulation community clinic in northern Israel. PATIENTS: Four hundred ninety pregnant women referred for thrombophilia screening. MAIN OUTCOME MEASURES: Screening results for thrombophilia and antithrombotic treatment with enoxaparin, aspirin, or both and pregnancy outcomes...
October 30, 2016: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/27780546/the-placental-component-and-obstetric-outcome-in-severe-preeclampsia-with-and-without-hellp-syndrome
#7
Eran Weiner, Letizia Schreiber, Ehud Grinstein, Ohad Feldstein, Noa Rymer-Haskel, Jacob Bar, Michal Kovo
OBJECTIVE: We aimed to compare obstetric outcome and placental-histopathology in pregnancies complicated by preeclampsia with severe features with and without HELLP syndrome. METHODS: Labor, maternal characteristics, neonatal outcome and placental histopathology of pregnancies complicated with severe preeclampsia during 2008-2015 were reviewed. Results were compared between those without signs of HELLP syndrome (severe preeclampsia group) and those with concomitant HELLP syndrome (HELLP group)...
November 2016: Placenta
https://www.readbyqxmd.com/read/27766963/associations-of-recurrent-miscarriages-with-chromosomal-abnormalities-thrombophilia-allelic-polymorphisms-and-or-consanguinity-in-saudi-arabia
#8
Rola F Turki, Mourad Assidi, Huda A Banni, Hanan A Zahed, Sajjad Karim, Hans-Juergen Schulten, Muhammad Abu-Elmagd, Abdulrahim A Rouzi, Osama Bajouh, Hassan S Jamal, Mohammed H Al-Qahtani, Adel M Abuzenadah
BACKGROUND: Recurrent pregnancy loss (RPL) or recurrent spontaneous abortion is an obstetric complication that affects couples at reproductive age. Previous reports documented a clear relationship between parents with chromosomal abnormalities and both recurrent miscarriages and infertility. However, limited data is available from the Arabian Peninsula which is known by higher rates of consanguineous marriages. The main goal of this study was to determine the prevalence of chromosomal abnormalities and thrombophilic polymorphisms, and to correlate them with RPL and consanguinity in Saudi Arabia...
October 10, 2016: BMC Medical Genetics
https://www.readbyqxmd.com/read/27766527/high-prevalence-of-congenital-thrombophilia-in-patients-with-pregnancy-related-or-idiopathic-venous-thromboembolism-pulmonary-embolism
#9
Makoto Ikejiri, Hideo Wada, Norikazu Yamada, Maki Nakamura, Naoki Fujimoto, Kaname Nakatani, Akimasa Matsuda, Yosihito Ogihara, Takeshi Matsumoto, Yuki Kamimoto, Tomoaki Ikeda, Naoyuki Katayama, Masaaki Ito
Congenital thrombophilia which is characterized by deficiencies in proteins such as antithrombin (AT), protein C (PC) and protein S (PS), is a major cause of venous thromboembolism (VTE). A total of 130 patients with VTE were evaluated for congenital thrombophilia based on the activity of AT, PC, or PS. Fifteen VTE patients with congenital AT deficiency (11.5 %), 16 with congenital PC deficiency (12.3 %) and eight with congenital PS deficiency (6.2 %) were diagnosed using DNA analysis. The frequency of congenital AT deficiency was significantly higher in subjects with pregnancy-related and idiopathic VTE than in those with VTE due to other causes, and congenital PC and PS deficiency were frequently associated with idiopathic VTE...
October 20, 2016: International Journal of Hematology
https://www.readbyqxmd.com/read/27766051/thrombophilia-in-east-asian-countries-are-there-any-genetic-differences-in-these-countries
#10
Toshiyuki Miyata, Keiko Maruyama, Fumiaki Banno, Reiko Neki
In recent years, genetic analyses of congenital deficiencies of three anticoagulant proteins, antithrombin, protein C (PC) and protein S (PS), in East Asian patients with venous thromboembolism (VTE) have greatly increased. The PS-K196E mutation is often identified in the Japanese population with an allelic frequency of 0.86 %, and a total of approximately 10,000 Japanese are estimated to be homozygotes. The heterozygotes show PS anticoagulant activities ranging from 40 to 110 %, and 16 % lower mean anticoagulant activity than that in wild-type individuals...
2016: Thrombosis Journal
https://www.readbyqxmd.com/read/27759443/epidemiology-of-critical-states-during-pregnancy-after-assisted-reproductive-technologies
#11
N V Bashmakova, N B Davydenko, G B Malgina, N V Putilova
AIM: The aim of this research was to have a thorough study of predictors of critical states during pregnancy after assisted reproductive technologies. MATERIALS AND METHODS: A retrospective study of 303 patients with "near-miss," out of which 37 are pregnancy cases after ART (the main group) and 265 are spontaneous pregnancy cases (the control group). RESULTS: Pregnancy after ART constituted 12.3% of all critical states. In the main group (10...
October 2016: Gynecological Endocrinology
https://www.readbyqxmd.com/read/27720497/low-molecular-weight-heparin-and-recurrent-placenta-mediated-pregnancy-complications-a-meta-analysis-of-individual-patient-data-from-randomised-controlled-trials
#12
Marc A Rodger, Jean-Christophe Gris, Johanna I P de Vries, Ida Martinelli, Évelyne Rey, Ekkehard Schleussner, Saskia Middeldorp, Risto Kaaja, Nicole J Langlois, Timothy Ramsay, Ranjeeta Mallick, Shannon M Bates, Carolien N H Abheiden, Annalisa Perna, David Petroff, Paulien de Jong, Marion E van Hoorn, P Dick Bezemer, Alain D Mayhew
BACKGROUND: Placenta-mediated pregnancy complications include pre-eclampsia, late pregnancy loss, placental abruption, and birth of a small-for-gestational-age (SGA) neonate. These complications are leading causes of maternal, fetal, and neonatal morbidity and mortality in high-income countries. Affected women are at high risk of recurrence in subsequent pregnancies; however, effective strategies to prevent recurrence are absent. Findings from our previous study-level meta-analysis suggested that low-molecular-weight heparin reduced the risk of recurrent placenta-mediated pregnancy complications...
November 26, 2016: Lancet
https://www.readbyqxmd.com/read/27677928/birthweight-in-pregnant-women-with-protein-s-deficiency-treated-with-low-molecular-weight-heparin-a-retrospective-cohort-study
#13
Juan Jesús Fernández-Alba, Carmen González-Macías, Angel Vilar Sánchez, Pilar Tajada Cepero, Raquel Garrido Teruel, María José García-Cabanillas, Luis Javier Moreno-Corral, Rafael Torrejón Cardoso
OBJECTIVE: To determine the risk of small-for-gestational-age (SGA) and intrauterine growth retardation (IUGR) in pregnant women with protein S (PS) deficiency who received low-molecular-weight heparin (LMWH). METHODS: Retrospective cohort study of pregnant women seen from January 2002 to December 2011. The study cohort comprised a total of 328 patients with PS deficiency, who received prophylactic enoxaparin during pregnancy. The control cohort included 11 884 pregnant women without significant past medical history...
October 17, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27668201/etiologic-characteristics-and-index-pregnancy-outcomes-of-recurrent-pregnancy-losses-in-korean-women
#14
Gi Su Lee, Joon Cheol Park, Jeong Ho Rhee, Jong In Kim
OBJECTIVE: The goal of this study was to evaluate the etiologies and clinical outcomes of Korean recurrent pregnancy loss (RPL) patients. And also, we investigated the differences between primary and secondary RPL patients, between two and three or more pregnancy losses. METHODS: One hundred seventy eight women diagnosed as RPL were enrolled. We performed chromosomal analysis, thyroid stimulating hormone, prolactin, blood glucose, plasminogen activator inhibitor-1, natural killer cell proportion, anticardiolipin antibodies, antiphospholipid antibodies, lupus anticoagulant, anti-β2glycoprotein-1 antibodies, antinuclear antibody, protein C, protein S, antithrombin III, homocysteine, MTFHR gene, factor V Leiden mutation, and hysterosalphingography/hysteroscopic evaluation...
September 2016: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/27638899/management-of-inherited-thrombophilia-in-pregnancy
#15
Laura Ormesher, Louise Simcox, Clare Tower, Ian A Greer
Adverse pregnancy outcomes, such as pregnancy loss and pre-eclampsia, are associated with thrombotic mechanisms and thrombophilia. Antithrombotic interventions, particularly low-molecular-weight heparin, have been investigated in women identified by previous pregnancy outcome; however, the results have been inconsistent. This may reflect heterogeneity of both the study groups and the disease processes resulting in inadequate stratification to guide antithrombotic interventions. Furthermore, the variation in gestation at initiation of low-molecular-weight heparin treatment might be important...
July 2016: Women's Health
https://www.readbyqxmd.com/read/27631133/antibodies-directed-against-annexin-a2-and-obstetric-morbidity
#16
V Salle, J Schmidt, A Smail, C Mazière, M A Conte, A Brulé, J C Mazière, E Cadet, Y E Herpe, P Duhaut
Acquired and inherited thrombophilia have both been reported to be associated with an increased risk of obstetric complications in early or later stages of pregnancy. Annexin A2 (ANXA2) is strongly expressed in vascular and placental tissues and plays a crucial role in fibrinolysis. The aim of the present study was to evaluate the prevalence of antibodies directed against ANXA2 in patients with recurrent miscarriage or obstetric complications. Anti-ANXA2 antibodies (aANXA2) were detected by ELISA in the sera from 46 women with obstetric morbidity, mainly recurrent miscarriage...
August 30, 2016: Journal of Reproductive Immunology
https://www.readbyqxmd.com/read/27629134/does-anticoagulant-therapy-improve-adverse-pregnancy-outcomes-in-patients-with-history-of-recurrent-pregnancy-loss
#17
Oner Aynıoglu, Hatice Isik, Ahmet Sahbaz, Husnu Alptekın, Ulku Bayar
OBJECTIVES: Recurrent pregnancy loss (RPL) is a serious problem in the reproductive age women. We aimed to study the role of anticoagulant therapy on pregnancy complications and perinatal outcomes in pregnant patients with histories of RPL. MATERIAL AND METHODS: One hundred fifty-three pregnants, with RPL history and thrombophilia positivity, were grouped into two as 89 treated with anticoagulant therapy and 64 non-treated. Treated and untreated groups were compared for pregnancy complications, delivery weeks, abortion rates, fetal birth weights, APGAR scores, live birth rates, and newborn intensive care admission rates...
2016: Ginekologia Polska
https://www.readbyqxmd.com/read/27614329/placental-histopathology-lesions-and-pregnancy-outcome-in-pregnancies-complicated-with-symptomatic-vs-non-symptomatic-placenta-previa
#18
Eran Weiner, Hadas Miremberg, Ehud Grinstein, Letizia Schreiber, Shimon Ginath, Jacob Bar, Michal Kovo
BACKGROUND: The mechanisms involved in bleeding in cases of placenta previa (PP) and the effect on pregnancy outcome is unclear. OBJECTIVES: We aimed to compare pregnancy outcome and placental histopathology in pregnancies complicated with symptomatic (bleeding) vs. non-symptomatic PP, and to study the effects of the co-existence of histopathological retro-placental hemorrhage (RPH) in cases of symptomatic PP on neonatal and maternal outcomes. STUDY DESIGN: Labor and maternal characteristics, neonatal outcome and placental histopathology lesions of pregnancies with PP, delivered between 24 and 42weeks, during 2009-2015, were reviewed...
October 2016: Early Human Development
https://www.readbyqxmd.com/read/27614189/pregnancy-and-non-pregnancy-related-ovarian-vein-thrombosis-clinical-course-and-outcome
#19
Amihai Rottenstreich, Nael Da'as, Geffen Kleinstern, Galia Spectre, Hagai Amsalem, Yosef Kalish
OBJECTIVE: To collect and summarize demographic, clinical, laboratory and radiologic characteristics, as well as management and follow-up data, of patients diagnosed with ovarian vein thrombosis. METHODS: A multicenter retrospective review of all patients diagnosed with ovarian vein thrombosis between January 2000 and May 2015 at three university hospitals. RESULTS: Data of 74 women were analyzed. Mean age was 31±9years. Sixty (81.1%) cases were pregnancy-related...
October 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27613196/hereditary-risk-factors-of-thrombophilia-and-probability-of-venous-thromboembolism-during-pregnancy-and-the-puerperium
#20
Andrea Gerhardt, Rüdiger E Scharf, Ian A Greer, Rainer B Zotz
Venous thromboembolism (VTE) is a leading cause of maternal mortality. Few studies have evaluated the individual risk of gestational VTE associated with heritable thrombophilia and current recommendations for antenatal thromboprophylaxis in women with severe thrombophilia such as homozygous factor V Leiden mutation (FVL) depend on a positive family history of VTE. To better stratify thromboprophylaxis in pregnancy, we aimed to estimate the individual probability (absolute risk) of gestational VTE associated with thrombophilia and whether these risk factors are independent of a family history of VTE in first-degree relatives...
September 9, 2016: Blood
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