Marinov B, Pramatarova T, Andreeva A, Iarukova N, Slavov A
Akush Ginekol (Sofiia). 2011;50(6):15-7.
It has become clear in the recent years that inherited thrombophilias (IT) are associated with serious abnormalities during pregnancy. This includes miscarriage, still birth, placental abruption, praeclamcspia and intrauterine fetal growth restriction. The aim of this study is to share our experience in the field.
38 patients with medical history of abnormal pregnancies (miscarriage, still birth, placental abruption, praeclamcspia and intrauterine fetal growth reastriction). They were all tested for the following gene alterations: V Laidon-R506Q/phiVL-R506Q/, protrombin G/A 20210 /Pi pG/A20210/, Plasminogen activator inhibitor- PAI- 4G/4G/PAI 4G/5G/). IT were diagnosed in 24 patients. They were all treated by: Aspirin 75 mg form prior to conception and low molecular Heparin after detection of fetal heart movement. Due to the observed NRDS in some of the newborns, the low molecular heparin intake was discontinued 30 days prior to expected delivery.
keeping up to the therapeutic scheme, 70% (17) of women with IT gave birth to a term baby, and 30% (7)-to a preterm one, all pregnancies were successful. Amongst the patients with medical history of miscarriage, 72% were diagnosed with IT and 87.5% of them gave birth to a term newborn as a result of the anticoagulant treatment.
Undiagnosed IT is a common cause of adverse pregnancy outcome. Uninterrupted anticoagulant treatment of these patients is very successful. The whole pregnancy should be followed up closely. Due to the higher risk of respiratory complications in the infants, delivery should be performed in a specialized hospital with neonatology department, capable of newborn resuscitation.
近年来已明确，遗传性易栓症（IT）与孕期严重异常情况相关。这包括流产、死产、胎盘早剥、子痫前期和胎儿宫内生长受限。本研究的目的是分享我们在该领域的经验。
38例有异常妊娠病史（流产、死产、胎盘早剥、子痫前期和胎儿宫内生长受限）的患者。对他们均进行了以下基因改变检测：V Leiden - R506Q/phiVL - R506Q/、凝血酶原G/A 20210 /Pi pG/A20210/、纤溶酶原激活物抑制剂 - PAI - 4G/4G/PAI 4G/5G/）。24例患者被诊断为遗传性易栓症。她们均接受以下治疗：受孕前服用75毫克阿司匹林，检测到胎心后使用低分子肝素。由于部分新生儿出现了观察到的新生儿呼吸窘迫综合征，在预期分娩前30天停用低分子肝素。
按照治疗方案，70%（17例）遗传性易栓症女性足月分娩，30%（7例）早产，所有妊娠均成功。在有流产病史的患者中，72%被诊断为遗传性易栓症，其中87.5%因抗凝治疗足月分娩。
未诊断出的遗传性易栓症是不良妊娠结局的常见原因。对这些患者进行不间断的抗凝治疗非常成功。整个孕期应密切随访。由于婴儿发生呼吸并发症的风险较高，应在设有新生儿科、具备新生儿复苏能力的专科医院进行分娩。
