Department of Medicine, McMaster University, Hamilton General Hospital, 237 Barton Street East, Hamilton, Ontario, Canada.
Expert Rev Hematol. 2009 Apr;2(2):183-96. doi: 10.1586/ehm.09.8.
Pregnancy is associated with an increased risk of venous thromboembolism (VTE) and approximately half of all pregnancy-related VTEs are associated with thrombophilia. Recent studies suggest that there is a link between thrombophilia and other adverse pregnancy outcomes, such as fetal loss, preeclampsia, placental abruption and intrauterine growth restriction. However, the associations reported are modest, and high quality data are limited. Although the most compelling data derive from pregnant women with antiphospholipid antibodies, the use of anticoagulants for the prevention of pregnancy complications other than VTE in women with heritable thrombophilias is becoming more frequent. In this article, we review the impact of the various thrombophilias on pregnancy and its outcome, the evidence for therapies aimed at prevention of thrombophilia-related pregnancy complications, and briefly discuss the role of screening for thrombophilia in pregnancy.
妊娠与静脉血栓栓塞症(venous thromboembolism,VTE)的风险增加相关,约一半的妊娠相关 VTE 与血栓形成倾向有关。最近的研究表明,血栓形成倾向与其他不良妊娠结局之间存在关联,如胎儿丢失、子痫前期、胎盘早剥和宫内生长受限。然而,报告的相关性是适度的,高质量的数据有限。尽管最有说服力的数据来自于抗磷脂抗体阳性的孕妇,但在遗传性血栓形成倾向的妇女中,除 VTE 以外,为预防妊娠并发症而使用抗凝剂的情况越来越多。在本文中,我们综述了各种血栓形成倾向对妊娠及其结局的影响、针对预防血栓形成倾向相关妊娠并发症的治疗方法的证据,并简要讨论了妊娠时血栓形成倾向筛查的作用。