Thrombophilia During Pregnancy: Symptoms, Diagnosis & Treatment!
Thrombophilia is an abnormality that represents a group of disorders that lead to blood clotting. Those who suffer from thrombophilia tend to have blood clots more easily, mostly because their bodies have:
- Too much of certain proteins, which are known as clotting factors, or;
- Too little proteins against clots.
Thrombophilia can be inherited or may occur lately when being older. Around 15% of citizens of the U.S. have inherited this abnormality. To contact this infection is a rare phenomenon, but if it happens, it may lead to various risks during pregnancy.
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Most people who experience thrombophilia don`t show any signs. Still, some of them develop thrombosis, but of which don`t involve blood clots. Often, blood clots form in veins of the lower part of the leg, leading to or discomfort, swelling or redness. The present medical condition, known as thrombosis, is often diagnosed in most cases by ultrasound or with the help of some tests. Clots are usually treated with anticoagulants.
Clots may affect someone`s life if they break and travel through blood towards the vital organs. This phenomenon is known as venous thromboembolism (VTE). When the process of thromboembolism leads to the blockage of blood vessels, pulmonary embolism occurs. It may cause serious difficulties regarding respiration, and there`s also the risk of death. VTE blocks blood vessels in the brain and heart, which may lead to heart attack or stroke.
It`s more likely for a person to develop clots if thrombophilia include other risk factors as well:
- The existence of a precedent in the family regarding VTE.
- Being pregnant or in the postnatal period (up to 6 months after birth).
- Immobilization due to a fracture, like a surgery.
Types of Thrombophilia
Inherited thrombophilia includes:
- Factor V Leiden and prothrombin mutations – there are probably the most common types of inherited thrombophilia. They occur from 2% to 7% in Caucasians and more rarely in African-Americans and Asians.
- Antihrombin, protein C and protein S deficient. Each of them affects less than 1% of people in the U.S.
All these are inherited from an autosomal dominant pattern, meaning that an affected person must inherit the gene from one of her persons. Each child of an affected parent has 50% chances of inheriting thrombophilia.
The most common type of thrombophilia is antiphospholipid syndrome (APS). This occurs in around 5% of pregnant women. In the case of APS, it should be noted that it produces antibodies to attack certain fats (phospholipids), and sometimes clots may even occur. Syndrome designates an autoimmune disease, such as arthritis or lupus erythematosus. Up to 40% from women suffering of this disease have antibodies in the blood, which contribute to the increased risk of certain complications during pregnancy.
Risks of Thrombophilia during Pregnancy
Most women with a tendency of developing blood clots have a healthy pregnancy. However, these women are more likely than other ones to the occurrence of blood clots in veins or other complications related to pregnancy.
Pregnant women are more likely than women who aren`t expecting a baby to developing blood clots and embolism. This fact is caused by normal changes in blood during pregnancy which limits blood loss during labor and delivery. However, studies show that at least 50% of women who develop pulmonary embolism or other similar medical conditions, have in fact thrombophilia. Pulmonary embolism causes deaths around the pregnant women in the U.S.
Thrombophilia may also contribute to pregnancy complications among which include:
- Recurrent miscarriages, which usually occurs after the weeks 10 of pregnancy.
- Fetal death during the second or third trimester of pregnancy.
- Placental abruption, a medical condition in which the placenta detaches from the uterine wall in part or completely before birth. This may cause severe bleeding which are dangerous for both the mother and baby.
Antophospholipid syndrome contributes to 10% – 20% of miscarriages. Also, it`s associated with other pregnancy complications:
- Preeclampsia. This form of pregnancy associated with a very high blood pressure which raises a lot of risks for both the mother and baby.
- Weak growth of the fetus.
- Premature birth (before the week 37 of pregnancy).
It`s necessary to do some blood tests to find out if you are suffering of this abnormality. – More info!
All pregnant women who previously had blood clots should make tests for diagnosing this medical abnormality. Experts may recommend doing these tests if:
- There`s a previous history in the family regarding thrombophilia before the age of 50.
- There`s a history of pregnancy complications, including 2 or more miscarriages after the week 10, fetal deaths, premature preeclampsia or other unexplained fetal growth problems.
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Treatments depend on the type of thrombophilia and if you previously confronted with blood clots. Some women who have this condition don`t need treatment.
Women who have thrombophilia, but also a history regarding blood clots, are in general treated with anticoagulants during pregnancy, but also after childbirth. However, women who suffer of a serious diseases or inherited thrombophilia (such as antithrombin deficiency), are usually treated, even if they don`t have blood clots. During pregnancy, they are treated with anticoagulants known as heparin, which is administered be injection once or a few times a day. Treatment may also include a new version of the drugs that is known as low molecular weight heparin. However, these medications don`t pass through the placenta and are safe for the baby. After birth, some of the women suffering from thrombophilia may be treated up to 6 weeks with anticoagulants administered orally, and which are known as warfarin, instead of heparin. Warfarin is safe even during breastfeeding, but it isn`t recommended during pregnancy because it can pass through the placenta and may cause birth defects. – Check this out!
Women with APS, who have a history regarding blood clots or recurrent miscarriages, are usually treated with anticoagulants, both during pregnancy and after birth. Small doses of aspirin are recommended along with heparin. Research show that a combination between the two drugs is a lot better than administering only one of them.
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Not all women with thrombophilia need treatment during pregnancy. A woman should talk to a specialist about the risks involving blood clots and any pregnancy complications, but also about the severity of the abnormality, before deciding if she needs treatment or not. Treatment with heparin may involve some risks, among which there are bone mass loss and possible dangerous changes in the blood. The risks are smaller when talking about heparin. – Read this!
Treatment may not be recommended for pregnant women with a severe form of thrombophilia, such as factor V Leiden or prothrombin mutations who don`t have a family history regarding blood clots. The risk of VTE is less than 0.2% in pregnant women with factor V Leiden who don`t have a strong family history on this matter. In some cases, treatment may be recommended after Caesarean birth.
There are studies about the genetic basis of numerous inherited diseases, some of them being closely related to these clots. Any future discoveries may lead to the improvement of treatments for inherited diseases, among which thrombophilia may be included.