[Our experience with management of inherited thrombophilia during pregnancy: preliminary report].

UNLABELLED

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.

MATERIALS AND METHODS

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/pG/A20210/, Plasminogen activator inhibitor- PAI- 4G/4G /PAI 4G/5G/). IT were diagnosed in 24 patients. They were all treated by: Aspirin 75mg 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.

RESULTS

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.

CONCLUSIONS

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.