Anticoagulant therapy and thromboprophylaxis in patients with thrombophilia.

OBJECTIVE

The aim of this review was to discuss the effectiveness of anticoagulant therapy and thromboprophylaxis in patients with thrombophilia.

METHODS

A MEDLINE search was performed using the keywords: "anticoagulant therapy", "pregnancy", "thromboprophylaxis", "thrombophilia", "adverse pregnancy outcomes", "venous thromboembolism", "heparin" and "low molecular weight heparin".

RESULTS

The identification of a link between thrombophilic factors and adverse pregnancy outcome offers treatment possibilities. Until recently, it has not been clear whether antithrombotic therapy is useful in women with previous placental dysfunction and inherited thrombophilia. Anticoagulant therapy is indicated during pregnancy for the prevention and treatment of venous thromboembolism, for the prevention and treatment of systemic embolism in patients with mechanical heart valves and, for the prevention of pregnancy complications in women with antiphospholipid antibody syndrome or other thrombophilic disorders and previous pregnancy complications. At present, limited data exist regarding the efficacy of anticoagulants during pregnancy. Recommendations are largely based on data extrapolated from non-pregnant patients, case reports, and case series of pregnant patients. Many physicians have been treating such women with antithrombotic therapy on the basis of logic and anecdotal evidence.

CONCLUSION

A regimen for thrombophylaxis and treatment of thrombophilic parturient based on thrombophilia type is proposed.