Haema 2014; 5(1):89-98
by Despoina Barbarousi, Trajce Enkeleida
Haematology Department, General Hospital Alexandra, Athens, Greece
Pregnancy per se is a prothrombotic state due to the increment of the levels of many coagulation factors, the reduction of certain coagulation inhibitors and the vasodilating action of estrogens. Venous thromboembolism contributes in the morbidity of pregnant women, whereas pulmonary embolism is the primary cause of maternal death in the developed countries. Thrombophilia, namely the inherited or acquired susceptibility to thrombosis attributed lately to the abnormal function or defficiency of quite a few coagulation proteins or inhibitors, multiplies the risk of thrombosis during pregnancy specially when additional predisposing factors are present. Thrombophilia has also been related with obstetric complications and poor pregnancy outcome (fetal loss, pre-eclampsia, placental abruption, intrauterine growth retardation – IUGR) since thrombosis in the placental circulation is considered to be the possible under- lying pathogenesis of the above disorders. Nevertheless, no prompt evidence supports this correlation, with the exception of antiphospholipid syndrome. Furthermore there is no clear evidence, based on well designed randomized trials, to justify the use of thrombophilia testing as ‘screening’ to predict obstetric complications in pregnant women population or much more, the use of anticoagulants to prevent them.