Why the study?
Does targeted prophylaxis improve pregnancy outcomes in women with a history of pregnancy complications and thrombophilic markers?
Does targeted prophylaxis improve pregnancy outcomes in women with a history of pregnancy complications and thrombophilic markers?
In women with a history of pregnancy complications and thrombophilic markers, targeted prophylaxis yielded 100% successful pregnancy outcomes, though untreated women also demonstrated a high rate (93%) of positive outcomes.
High success rates with or without prophylaxis should not change practice; leaves open benefit of targeted therapy pending randomized trials.
A significant number of pregnancy related disorders is associated with protrombotic abnormalities and consequent risk of maternal and fetal complications. Aim of the study was to research thrombophilic markers and comorbidities in a group of women with personal or familial history of these pathologies. We analyzed 207 patients referred to Haemostasis Diseases Unit, looking for ineredithed and acquired thrombophilic markers. We observed 75 coagulation factor mutations (36.2%), 7 deficiencies of natural anticoagulants (3.3%) and 41 antiphosfolipid antibodies positivity (19.9%). The prevalence was higher than that observed in general population, with exception for the obstetric complications group, where others risk factors can play an important role. From history and laboratory exams, we suggested a therapy in 84 women (40%); indication to a prophylaxis in the group of pregnant women was given to 44%, all with successful outcome, while in the other 56% without treatment, only one woman had pregnancy loss (93% positive outcomes). Outcome and the variability in treatments reflect the uncertainty in scientific literature.
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Gervaso et al. (2014) studied this question.
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