Key result
Maternal thrombophilias were identified in 40% of MFI, 23% of MPVFD, 71% of FTV, and 50% of FTV+MPVFD cases, with 77% being genetic.
Why the study?
Are maternal thrombophilias associated with specific placental lesions such as MFI, MPVFD, and FTV?
Observational (n=138)
Are maternal thrombophilias associated with specific placental lesions such as MFI, MPVFD, and FTV?
Maternal thrombophilias, particularly genetic ones like protein S deficiency, are frequently found in specific placental lesions, suggesting a need for maternal and potentially familial thrombophilia testing when these lesions are diagnosed.
Maternal thrombophilias frequently accompany FTV and related lesions; hypothesis-generating for targeted testing, with prospective studies needed before practice change.
Maternal floor infarction (MFI), massive perivillous fibrin deposition (MPVFD), and fetal thrombotic vasculopathy (FTV) are specific placental lesions with associations to recurrent adverse fetal outcomes and with maternal thrombophilia. We studied the frequency of a range of acquired and genetic maternal thrombophilias in MFI (40 cases), MPVFD (87 cases), FTV (7 cases), and FTV+MPVFD (4 cases). Thrombophilias were identified in 16 (40%), 20 (23%), 5 (71%), and 2 (50%) of these lesions, respectively. Seventy-seven percent of the identified thrombophilias were genetic, and 23% were acquired. The most common genetic thrombophilia was protein S deficiency, which constituted 14 of the 36 genetic thrombophilias (39%). We advocate full maternal thrombophilia testing when the diagnosis of MFI, MPVFD, and FTV is made by placental pathology examination. Because of the possible contribution of paternal thrombophilic mutations to the fetal genotype, it would be desirable to test the whole family as well.
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Gogia et al. (2008) conducted an observational in Specific placental lesions (MFI, MPVFD, FTV) (n=138). Specific placental lesions was evaluated on Frequency of maternal thrombophilias. Maternal thrombophilias were identified in 40% of MFI, 23% of MPVFD, 71% of FTV, and 50% of FTV+MPVFD cases, with 77% being genetic.
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