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Obstetrics & Gynecology:
doi: 10.1097/AOG.0b013e31817e8acc
Current Commentary

Inherited Thrombophilia and Pregnancy Complications Revisited

Rodger, Marc A. MD, FRCPC, MSc1,2; Paidas, Michael MD3; Claire, McLintock MBChB, FRACP, FRCPA4; Middeldorp, Saskia MD5; Kahn, Susan MD6; Martinelli, Ida MD7; Hague, William MD8; Rosene Montella, Karen MD9; Greer, Ian MD10

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Inherited thrombophilias are not yet established as a cause of placenta-mediated pregnancy complications, such as fetal growth restriction, preeclampsia, abruption, and pregnancy loss. An inherited thrombophilia is only one of many factors that lead to development of these diseases and is unlikely to be the unique factor that should drive management in subsequent pregnancies. The paucity of evidence for benefit, coupled with a small potential for harm, suggests that low molecular weight heparin should be considered an experimental drug for these indications until data from controlled trials are published. At present, women with a history of placenta-mediated pregnancy complications, with or without a thrombophilia, should be followed closely without routine prophylactic low molecular weight heparin other than for prevention of venous thromboembolism in limited circumstances.

© 2008 by The American College of Obstetricians and Gynecologists.


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