Inherited thrombophilias and adverse pregnancy outcomes: a review of screening patterns and recommendations

Obstet Gynecol Clin North Am. 2014 Mar;41(1):133-44. doi: 10.1016/j.ogc.2013.10.005. Epub 2013 Dec 10.

Abstract

Historically, much controversy has existed regarding the association of inherited thrombophilias with adverse pregnancy outcomes. The current guidelines do not recommend screening unless a personal history of venous thromboembolism is present, but the authors' survey of physician screening patterns has suggested that up to 40% of physicians may screen contrary to the current guidelines. This article summarizes the existing evidence for each inherited thrombophilia and reviews the current guidelines.

Keywords: Inherited thrombophilias; Intrauterine growth restriction; OB/GYN; Placental abruption; Preeclampsia; Pregnancy; Recurrent pregnancy loss.

Publication types

  • Review

MeSH terms

  • Abortion, Habitual / blood
  • Abortion, Habitual / etiology
  • Abortion, Habitual / genetics*
  • Antibodies, Anticardiolipin / blood
  • Factor V / genetics
  • Female
  • Fetal Growth Retardation
  • Genetic Testing*
  • Guideline Adherence
  • Humans
  • Lupus Coagulation Inhibitor / blood
  • Methylenetetrahydrofolate Reductase (NADPH2) / genetics
  • Mutation
  • Patient Selection
  • Practice Guidelines as Topic
  • Pre-Eclampsia / blood
  • Pre-Eclampsia / etiology
  • Pre-Eclampsia / genetics*
  • Pregnancy
  • Pregnancy Complications, Hematologic / blood
  • Pregnancy Complications, Hematologic / genetics*
  • Pregnancy Outcome
  • Protein C Deficiency / complications
  • Protein S Deficiency / complications
  • Prothrombin / genetics
  • Risk Factors
  • Thrombophilia / blood
  • Thrombophilia / complications
  • Thrombophilia / genetics*
  • Venous Thromboembolism / blood
  • Venous Thromboembolism / etiology
  • Venous Thromboembolism / genetics*

Substances

  • Antibodies, Anticardiolipin
  • Lupus Coagulation Inhibitor
  • factor V Leiden
  • Factor V
  • Prothrombin
  • MTHFR protein, human
  • Methylenetetrahydrofolate Reductase (NADPH2)