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Pregnancy 2023

Thrombophilia in pregnancy: what é, symptoms, risks and treatment

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Thrombophilia in pregnancy: what é, symptoms, risks and treatment
Thrombophilia in pregnancy: what é, symptoms, risks and treatment

Thrombophilia in pregnancy is characterized by an increased risk of blood clots, which can lead to thrombosis, stroke or pulmonary embolism, for example. This happens because the blood enzymes responsible for clotting stop working properly, which can happen due to several factors, including pregnancy.

Pregnancy is a risk factor for the development of thromboembolic events, which can cause symptoms such as swelling, skin changes, placental detachment, preeclampsia, changes in fetal growth, the occurrence of a premature birth or even a miscarriage.

Thus, if there is a greater risk of the woman developing thromboembolism or if she presents signs and symptoms of this alteration, it is important that she is regularly monitored by the obstetrician, as it may be necessary to undergo treatment with medications to avoid complications during pregnancy, such as insufficiency placenta, fetal distress or miscarriage.Learn more about thrombophilia.

Symptoms of thrombophilia in pregnancy

Most cases of thrombophilia in pregnancy do not lead to the appearance of signs or symptoms, however some women may present:

  • Swelling that happens overnight;
  • Changes to skin;
  • Changes in baby's growth;
  • Shortness of breath or difficulty breathing, which may indicate pulmonary embolism;
  • Increased blood pressure.

Furthermore, as a consequence of thrombophilia, there is a greater risk of detachment of the placenta, premature birth and abortion, and it is important that the obstetrician-gynecologist's guidelines before and during pregnancy are followed.

How the diagnosis is made

Exams to confirm thromboembolism in pregnancy are usually only indicated when the woman has some risk factors, not being indicated in a preventive way, that is, before pregnancy.Thus, the tests are indicated for women who have had a previous abortion, had preeclampsia or who have a personal or family history of thromboembolism or high-risk thrombophilia.

Thus, to assess the risk of thromboembolism in pregnancy, a Factor V Leiden test, a prothrombin mutation test, a protein C reactivity test and an antithrombin test may be indicated, and it is recommended that these exams are performed by women before pregnancy and who do not use anticoagulants.

Major risks

Thrombophilia in pregnancy can increase the risk of some complications for both the woman and the baby, the main ones being:

  • Abortion;
  • Decreased amount of oxygen reaching the baby, resulting in fetal distress;
  • Change in fetal growth;
  • Preeclampsia and eclampsia;
  • Placenta insufficiency and placental abruption.

Furthermore, in women already diagnosed with thromboembolism before becoming pregnant, it is possible that there is greater difficulty in implanting the embryo into the endometrium.

Causes of thrombophilia in pregnancy

Pregnancy induces a physiological state of hypercoagulability and hypofibrinolysis, which generally protects the pregnant woman from hemorrhage associated with childbirth, however this mechanism can contribute to the development of thrombophilia, which increases the risk of thrombosis. venous and obstetric complications.

The risk of thrombosis in pregnant women is 5 to 6 times greater than in non-pregnant women, however, there are other factors that increase the likelihood of developing a pregnancy-related thrombosis, such as having a history of venous thrombosis, having an advanced maternal age, suffering from obesity, or suffering from some type of immobilization, for example.

How the treatment is done

Generally, the treatment of venous thromboembolism in pregnancy consists of the administration of aspirin at a dose of 80 to 100 mg/day, which acts by inhibiting platelet aggregation. Although this medication is contraindicated during pregnancy, especially in the last trimester, as it poses a risk to the baby, the benefits of its use, in some situations, may outweigh the potential risks and, therefore, it may be recommended by the doctor.

In addition, injectable heparin, such as enoxaparin, is an anticoagulant widely used for thrombophilia in pregnancy, and is a safe drug because it does not cross the placental barrier. Enoxaparin must be administered daily, subcutaneously, and can be applied by the person himself. Treatment should be carried out even after delivery, for about 6 weeks.

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