Thrombophilia testing in pregnancy: should we agree to disagree?
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Laudelino Lopes
Abstract
The value of testing for inherited thrombophilia in pregnancy has been debated in literature with regard to its utility in preventing adverse obstetrical outcomes or identifying women at risk for it. In this commentary, an evidence based approach is used to investigate the strength of association between thrombophilias and recurrent pregnancy loss and stillbirth. Several studies and meta-analyses have shown that there is only a weak association with recurrent pregnancy loss. However, many of these studies were underpowered, and there was significant heterogeneity-issues that are addressed in this paper. The evidence for association with stillbirth is lacking, but the few studies that are available seem to suggest a stronger correlation than for recurrent pregnancy loss. Further, the benefit of treating thrombophilias with anticoagulation in order to prevent these outcomes is discussed. While there is a lack of evidence looking at whether anticoagulation prevents stillbirth, there is strong evidence to show that anticoagulation does not prevent recurrent pregnancy loss. Finally, guidelines put out by various obstetrical and hematological societies regarding this topic are summarized.
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The authors stated that there are no conflicts of interest regarding the publication of this article.
©2015 by De Gruyter
Articles in the same Issue
- Frontmatter
- Academy’s Corner
- Obstetrical Doppler: the evidence today
- Review article
- Fetal complications due to intrahepatic cholestasis of pregnancy
- Original articles – Obstetrics
- Pre-pregnancy obesity compromises obstetric and neonatal outcomes
- Novel application of three-dimensional HDlive imaging in prenatal diagnosis from the first trimester
- Placental gene expression of inflammatory markers and growth factors – a case control study of obese and normal weight women
- Haemorrhagic and thrombotic complications in pregnant women with acquired and congenital cardiac disease
- Intrapartum ultrasound prior to Kristeller maneuver: an observational study
- Interinstitutional variations in mode of birth after a previous caesarean section: a cross-sectional study in six German hospitals
- Use of the angle of progression on ultrasonography to predict spontaneous onset of labor within 7 days
- Study of the relationship in pregnant women between hepatitis B markers and a placenta positive for hepatitis B surface antigen
- Sarcoidosis and pregnancy: obstetrical and neonatal outcomes in a population-based cohort of 7 million births
- Original articles – Fetus
- MR imaging of the fetal brain at 1.5T and 3.0T field strengths: comparing specific absorption rate (SAR) and image quality
- Sex differences in the fetal heart rate variability indices of twins
- Original articles – Newborn
- Correlation of neonatal weight with maternal serum levels of pregnancy-associated plasma protein-A during the first trimester of pregnancy: a retrospective study
- Antenatal testing in uncomplicated pregnancies: should testing be initiated after 40 or 41 weeks?
- Low total IgM values and high cytomegalovirus loads in the blood of newborns with symptomatic congenital cytomegalovirus infection
- Associated anomalies in congenital diaphragmatic hernia: perinatal characteristics and impact on postnatal survival
- The value of lipopolysaccharide binding protein for diagnosis of late-onset neonatal sepsis in very low birth weight infants
- Is there a stepwise increase in neonatal morbidities according to histological stage (or grade) of acute chorioamnionitis and funisitis?: effect of gestational age at delivery
- Commentary
- Thrombophilia testing in pregnancy: should we agree to disagree?
- Congress Calendar
- Congress Calendar
Articles in the same Issue
- Frontmatter
- Academy’s Corner
- Obstetrical Doppler: the evidence today
- Review article
- Fetal complications due to intrahepatic cholestasis of pregnancy
- Original articles – Obstetrics
- Pre-pregnancy obesity compromises obstetric and neonatal outcomes
- Novel application of three-dimensional HDlive imaging in prenatal diagnosis from the first trimester
- Placental gene expression of inflammatory markers and growth factors – a case control study of obese and normal weight women
- Haemorrhagic and thrombotic complications in pregnant women with acquired and congenital cardiac disease
- Intrapartum ultrasound prior to Kristeller maneuver: an observational study
- Interinstitutional variations in mode of birth after a previous caesarean section: a cross-sectional study in six German hospitals
- Use of the angle of progression on ultrasonography to predict spontaneous onset of labor within 7 days
- Study of the relationship in pregnant women between hepatitis B markers and a placenta positive for hepatitis B surface antigen
- Sarcoidosis and pregnancy: obstetrical and neonatal outcomes in a population-based cohort of 7 million births
- Original articles – Fetus
- MR imaging of the fetal brain at 1.5T and 3.0T field strengths: comparing specific absorption rate (SAR) and image quality
- Sex differences in the fetal heart rate variability indices of twins
- Original articles – Newborn
- Correlation of neonatal weight with maternal serum levels of pregnancy-associated plasma protein-A during the first trimester of pregnancy: a retrospective study
- Antenatal testing in uncomplicated pregnancies: should testing be initiated after 40 or 41 weeks?
- Low total IgM values and high cytomegalovirus loads in the blood of newborns with symptomatic congenital cytomegalovirus infection
- Associated anomalies in congenital diaphragmatic hernia: perinatal characteristics and impact on postnatal survival
- The value of lipopolysaccharide binding protein for diagnosis of late-onset neonatal sepsis in very low birth weight infants
- Is there a stepwise increase in neonatal morbidities according to histological stage (or grade) of acute chorioamnionitis and funisitis?: effect of gestational age at delivery
- Commentary
- Thrombophilia testing in pregnancy: should we agree to disagree?
- Congress Calendar
- Congress Calendar
