Pabinger I, Nemes L, Rintelen C, Koder S, Lechler E, Loreth R M, Kyrle P A, Scharrer I, Sas G, Lechner K, Mannhalter C, Ehrenforth S
I Department of Internal Medicine, Division of Hematology/Blood Coagulation, University Hospital, Vienna, Austria.
Hematol J. 2000;1(1):37-41. doi: 10.1038/sj.thj.6200005.
To evaluate the pregnancy-associated risk of venous thromboembolism and the risk of stillbirth and miscarriage a multicenter, retrospective and controlled study was conducted in women carrying the homozygous factor V Leiden mutation and in an agematched control group of women from the normal population.
In 64 homozygous (median age 44 years, range 21-75 years) and in 52 control women from five different centers data on venous thromboembolism and pregnancy outcome were obtained.
The 64 homozygous women had in total 212 pregnancies, the 52 control women had 118 pregnancies. In homozygous women 65% of pregnancies ended with delivery of a viable infant, 15% with fetal loss (3.3% stillbirth, 12% miscarriage) and 20% by pregnancy termination. In the control women 75% of pregnancies ended with delivery of a viable infant, 12% with fetal loss (1.7% stillbirth, 10% miscarriage) and 13% by pregnancy termination. The differences were statistically not significant. Venous thromboembolism occurred significantly more often in the homozygous women, in 4.2% (9/212) during pregnancy and in 4.7% (10/212) after delivery or pregnancy termination. None of the control women had a thromboembolic episode.
Our data indicate that women with homozygous factor V Leiden have a high probability for a favorable pregnancy outcome. The increased risk for venous thromboembolism during pregnancy and after delivery would favor heparin prophylaxis during and after pregnancy in women homozygous for factor V Leiden.
为了评估与妊娠相关的静脉血栓栓塞风险以及死产和流产风险，对携带纯合子因子V莱顿突变的女性和来自正常人群的年龄匹配对照组女性进行了一项多中心、回顾性和对照研究。
从五个不同中心获取了64名纯合子女性（中位年龄44岁，范围21 - 75岁）和52名对照女性的静脉血栓栓塞及妊娠结局数据。
64名纯合子女性共有212次妊娠，52名对照女性有118次妊娠。纯合子女性中65%的妊娠以活产结束，15%以胎儿丢失告终（3.3%为死产，12%为流产），20%以终止妊娠结束。对照女性中75%的妊娠以活产结束，12%以胎儿丢失告终（1.7%为死产，10%为流产），13%以终止妊娠结束。这些差异无统计学意义。静脉血栓栓塞在纯合子女性中发生得更为频繁，孕期为4.2%（9/212），产后或终止妊娠后为4.7%（10/212）。对照女性中无人发生血栓栓塞事件。
我们的数据表明，携带纯合子因子V莱顿突变的女性妊娠结局良好的可能性很高。孕期和产后静脉血栓栓塞风险增加，这表明对于因子V莱顿纯合子女性，孕期和产后应进行肝素预防性治疗。
