Table of Contents
Thrombosis
Volume 2013 (2013), Article ID 516420, 9 pages
http://dx.doi.org/10.1155/2013/516420
Review Article

The Role of Thrombophilia in Pregnancy

1Brigham and Women’s Hospital, Division of Hematology, 75 Francis Street, Boston, MA 02115, USA
2Dana-Farber Cancer Institute, Department of Hematology and Medical Oncology, 450 Brookline Avenue, Smith 353, Boston, MA 02115, USA

Received 7 July 2013; Accepted 13 November 2013

Academic Editor: Edith Nutescu

Copyright © 2013 Elisabeth M. Battinelli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Thrombotic disease is a major cause of peripartum morbidity and mortality worldwide. Development of thrombosis in pregnancy is multifactorial due to the physiologic changes of pregnancy—which induce a relative hypercoagulable state—as well as physical changes leading to increased stasis and also the effects of both the inherited and the acquired thrombophilias. In this review, we discuss the impact of each of these factors on the development of thrombosis as well as the evidence for the impact of pregnancy-associated thrombosis on pregnancy outcome. We then discuss the use of both prophylactic and therapeutic anticoagulation during pregnancy and the puerperium. We review the indications and dosing recommendations for administration of anticoagulation in a context of discussing the evidence including the lack of evidence and formal guidelines in this area. We briefly address the role of the new oral anticoagulants in pregnancy and conclude that significant further research in women with thrombophilias and pregnancy-associated thrombosis may help clarify the management of this condition in the future.