Thrombophilia increases blood clotting in the body, and people with this condition are more prone to thrombosis. Thrombosis is the formation of clots in the veins, potentially causing blockages. Thrombophilia means a person is at greater risk of developing some type of thrombosis, either due to hereditary reasons or acquired over time for some reason. But during pregnancy, how can thrombophilia affect you? How can it be diagnosed? Thrombophilia is most often discovered in women who have recurrent miscarriages. Until it manifests as thrombosis itself, thrombophilia is not easily detected. Although it commonly appears during pregnancy, it can happen anywhere in the body. The most frequent occurrence is a blockage in the legs, due to blood flow. It’s very common to hear about leg thrombosis.
How to Diagnose Thrombophilia
Blood tests and the patient’s family history should be considered by the doctor who suspects the condition. Based on this, they may order tests to determine if thrombophilia is hereditary or acquired. If it’s hereditary, the alterations speak for themselves, but if acquired, the following changes may appear in the exam:
Most cases of spontaneous miscarriage are caused by thrombophilia factors due to a mutation in factor V Leiden; in this case, factor V prevents protein C from being present in ideal quantities in the body, causing problems. The antithrombin factor is the natural productive deficiency of the protein C component. However, not only these factors can contribute to recurrent miscarriages, and it may prevent a pregnancy from progressing, so it must be investigated by a specialist as soon as thrombophilia is suspected.
Another aspect of thrombophilia is the risk during pregnancy. Suppose it’s not detected before pregnancy and is only discovered during gestation after an obstruction crisis that affects an important route for the fetus, for example, the umbilical cord, which provides oxygen and nutrition from the mother. The risk of premature birth or even a miscarriage in advanced gestational age is very high. That’s why diagnosis should be done before pregnancy in women who have had recurrent miscarriages, so treatment can start as soon as possible.
Preeclampsia is another aspect to consider when there are signs of thrombophilia. If the pregnant woman has high blood pressure, the doctor should check for changes in lab tests, such as the presence of protein C and S; if not present, medication should be started immediately. Cases at risk of preeclampsia, as well as HELLP syndrome andplacental abruption, should be closely monitored by a doctor. The success rate for a well-monitored and treated pregnancy is very high, exceeding 70% of full-term babies. Treating thrombophilia is straightforward for both pregnant and non-pregnant women—the important thing is diagnosis. Medications are always based on anticoagulants and agents that thin the blood, such as acetylsalicylic acid, with low-dose aspirin for non-pregnant women, the same used for stroke cases, for example.
The benefits it provides are immense, and circulation increases significantly. When used in pregnant women, as delivery approaches, the doctor may stop the medication that thins the blood, since it can cause hemorrhaging during labor. That’s why it should be discontinued at least 15 days before delivery. Other precautions will be taken at delivery, and medications given through IV may be used to prevent any hemorrhage.
Injectable or implanted heparin is frequently used as treatment in pregnant women; it acts as an anticoagulant and poses no risk to the baby. The use of heparin in pregnant women with thrombophilia is essential to prevent actual thrombotic problems during pregnancy, and avoiding vein obstruction is vital for the health of both mother and baby. The key is diagnosis and treatment—a woman with thrombophilia can indeed become a mother, as long as the problem is identified and treated as early as possible.
See also: From the Positive Test to Melissa’s Birth Story – Risk of Preeclampsia
