[4] Thrombophilia In Pregnancy Flashcards
What percentage of VTE’s in pregnancy are caused by thrombophilias?
20-50%
Why are women with thrombophila at an increased risk of VTE because of pregnancy?
Pregnancy is a pro-thrombotic state
Why must an individual’s management of thrombophilia in pregnancy be individualised?
Different thrombophilas have different levels of clotting risk
Is VTE the only risk of thrombophilia in pregnancy?
No
What are the other associated risks of factor C Leiden in pregnancy?
- Fetal loss
- Pre-eclampsia
- Placental abruption
- In-utero growth restriction
What are the other associated problems of anti-phospholipid syndrome?
- Recurrent miscarriage
- Fetal death
- Premature birth secondary to placental disease
When should screening for thrombophilias be offered to pregnant women or those looking to conceive?
- Personal or family history of VTE
- Recurrent miscarriage
- Early onset pre-eclampsia
- Absorption
Why can thrombophilia screening tests be unreliable in pregnancy?
There are changes to the haemopoietic system
When is the ideal time for thrombophilia screening (in relation to pregnancy)?
- Pre-conception
- Postnatally after an adverse event in pregnancy
Where should women with thrombophilia in pregnancy be managed?
In a combined obstetric-haematology clinic
Is LMWH safe in pregnancy?
Yes
What treatments are available to reduce the risk of VTE in thrombophilia in pregnancy?
- Antenatal and/or postnatal LMWH
- Compression stockings
- Avoid dehydration
When should care be taken with LMWH in pregnancy?
Timing its use around birth to minimise the risk of bleeding and ensure full range of analgesic options
