Abstract
Introduction
The association between thrombophilia and recurrent pregnancy loss (RPL) has become an undisputed fact. Thorombophilia leads to a hypercoaguable state which in turn leads to arterial and/or venous thrombosis at the site of implantation of embryo or in the placental bed blood vessels. Anticoagulants are suggested to be an effective treatment against RPL in women with acquired thrombophilia due to antiphospholipid syndrome. However the use of anticoagulants in treatment of RPL in women with inherited thrombophilia (IT) are also satisfactory. Although the reported side-effects for anticoagulants are rare and usually reversible, the current recommendation is not to use anticoagulants in women with RPL and IT, or for those with unexplained losses. This review examines the strength of the association between thrombophilia and RPL.
References
- Sarig G, Younis JS, Hoffman R, Lamir N, Blumenfeld Z,Brenner B. Thrombophilia is common in women with idiopathic pregnancy loss and is associated with late pregnancy wastage. Fertil Steril 2002; 77:342–7.
- Brenner B, Sarig G, Weiner Z, Younis J, Blumenfeld Z, Lanir N. Thrombophilic polymorphisms are common in women with fetal loss without apparent cause. Thromb Haemost 1999; 82:6–9.
- Regan L, Rai R . Epidemiology and the medical causes of miscarriage. Baillieres Best Pract Res Clin Obstet Gynaecol 2000; 14:839–54.
- Sanson BJ, Friederich PW, Simioni P, Zanardi S, Hilsman MV, Girolami A, et al. The risk of abortion and stillbirth in antithrombin-, protein C-, and protein S-deficient women. Thromb Haemost 1996; 75:387–8.
- Finan RR, Tamim H, Ameen G, Sharida HE, Rashid M, Almawi WY. Prevalence of factor V G1691A (factor V-Leiden) and prothrombin G20210A gene mutations in a recurrent miscarriage population. Am J Hematol 2002;71:300–5.
- Lockwood CJ. Inherited thrombophilias in pregnant patients: Detection and treatment paradigm. Obstet Gynecol 2002; 99:333–41.
- Nair RR, Khanna A, Singh K. MTHFR C677T polymorphism and recurrent early pregnancy loss risk in north Indian population. Reprod Sci 2012; 19:210–5.
- Hossain N, Shamsi T, Soomro N. Frequency of thrombophilia in patients with adverse pregnancy outcome. J Pak Med Assoc 2005; 55:245–7.
Corresponding Author
Dr Ankita Jamwal
Junior Resident Department of Obstetrics and Gynaecology, IGMC Shimla, India