Semin Thromb Hemost 2019; 45(01): 050-060
DOI: 10.1055/s-0038-1657782
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Inherited Thrombophilia and Pregnancy Complications: Should We Test?

Deepa R.J. Arachchillage
1  Department of Haematology, Imperial College Healthcare NHS Trust and Imperial College London, Hammersmith Hospital, London, United Kingdom
2  Department of Haematology, Royal Brompton Hospital, London, United Kingdom
,
Mike Makris
3  Sheffield Haemophilia and Thrombosis Centre, Royal Hallamshire Hospital, Sheffield, United Kingdom
4  Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
› Author Affiliations
Further Information

Publication History

Publication Date:
04 June 2018 (eFirst)

Abstract

Recurrent miscarriages and pregnancy-related complications cause significant stress to couples looking for successful pregnancy outcome as well as to health care professionals. There is conflicting evidence with respect to the presence and the strength of associations between inherited thrombophilia and these complications. A complete thrombophilia screen is expensive, and no proven effective treatment for women with recurrent miscarriage and inherited thrombophilia is currently available. Based on the concept of microvascular thrombosis of the placenta, women with recurrent miscarriage and placenta-related complications frequently get treated with antithrombotic therapy. In this narrative review, the authors explore the evolving understanding and evidence of inherited thrombophilia in recurrent miscarriages and other pregnancy complications, and whether antithrombotic treatment would modify pregnancy outcome in women with inherited thrombophilia. Finally, they provide some personal recommendations based on available evidence for clinical practice. In summary, inherited thrombophilia testing is not required outside a clinical trial for women with recurrent pregnancy losses or late pregnancy complications. The presence of thrombophilia markers does not generally indicate additional therapy during pregnancy, even if a heritable thrombophilic defect is found in women with recurrent miscarriages or late pregnancy complications.

Author Cpntributions

D. R. J. Arachchillage performed the literature search and wrote the first draft, and M. Makris reviewed the manuscript. Both authors approved the final manuscript.