Inherited thrombophilia influences localization and extent of pregnancy related deep venous thrombosis

Abstract

Background:Venous thromboembolism is one of the leading causes ofmaternal morbidity and mortality. The role of inherited thrombophiliain occurrence and localization of pregnancy related thrombosis is notclear.Aims:To investigate the influence of hereditary thrombophilia onlocalization and extent of thrombosis in women with thromboemboliccomplications during pregnancy and puerperium.Methods:We conducted a retrospective analysis of 212 consecutivewomen with pregnancy related deep vein thrombosis of lower extremi-ties (LE) or pulmonary embolism (PE) who were referred to our insti-tution for thrombophilia testing from January 2004 to December2015. When DVT of LE was present with PE, the event was accountedas PE. Thrombosis of superficial veins was excluded. All thromboticepisodes were confirmed with duplex ultrasonography and CT pneu-moangiography. In all women following causes of hereditary throm-bophilia were tested: factor V Leiden and prothrombin G20210Amutations, antithrombin, protein C and protein S deficiency. Bloodfor thrombophilia testing was obtained at least 3 months after cessa-tion of anticoagulant therapy.Results:Out of 212 women with pregnancy related thrombosis, 33(15,6%) developed PE, 73 (34,4%) developed unilateral thrombosis ofboth proximal and distal veins, 63 (29,7%) of proximal, and 36 (17%)of distal veins. Seven women (3,3%) developed concomitant bilateralthrombosis of deep veins of lower extremities. Hereditary throm-bophilia testing was positive in 82/212 (38,7%) women. Prevalence ofinherited thrombophilia was significantly higher in women with mas-sive DVT (proximal+distal veins) and in women with isolated DVT ofproximal veins than in women with PE and isolated DVT of distalveins.Conclusions:According to our results, inherited thrombophilia influ-ences localization and extent of pregnancy related thrombosis. Surpris-ingly, prevalence of thrombophilia was low in women who developedpregnancy related pulmonary embolism.