Modern approaches to the treatment of pregnant women with a genetic predisposition to thrombophilia: A literature review
DOI:
https://doi.org/10.37800/RM.2.2023.60-67Keywords:
recurrent pregnancy loss, thrombophilia, heparin, pregnancy complications, low molecular weight heparins, anticoagulant therapyAbstract
Relevance: The prevalence of recurrent miscarriage is 1 to 5%. Since the etiology of this pathology is not completely known, the methods of diagnosis and treatment associated with managing these patients are limited. The attention of researchers is focused on an integrated approach to the study of genetic, endocrine, and immunological causes of hemostasis disorders and the treatment of these disorders, particularly thrombophilia since an association of this condition with an unfavorable pregnancy outcome has been established.
The study aimed to establish the prevalence of thrombophilia in women with recurrent miscarriages and to evaluate the effect of anticoagulant therapy by literature analysis.
Materials and Methods: The search strategy for publications included the search for literary sources on the research topic indexed in the e-Library, Pubmed, Web of Science, and Scopus databases. For this review, we studied publications published in English or Russian for the past decade, from 2013 to 2023. A total of 60 publications were analyzed, of which 34 articles corresponded to the purpose of the study.
Results: The literature review revealed evidence confirming the relationship between hereditary thrombophilia and obstetric complications. However, insufficient studies were made to identify markers of thrombophilia in patients with reproductive insufficiency. The features of managing pregnant women with genetically determined thrombophilias are considered.
The data of clinical studies of anticoagulant therapy in women with reproductive failure and hereditary thrombophilia are presented, the results of which suggest that anticoagulant drugs with aspirin can improve the outcome of pregnancy in patients with recurrent miscarriage and hereditary thrombophilia.
Conclusion. To date, there has been an insufficient number of studies aimed at identifying relevant markers of thrombophilia in patients with reproductive insufficiency. It is suggested that markers such as PS, AT, MTHFR, and FVL can be used to assess the propensity for thrombophilia in women with reproductive insufficiency. Although this issue remains debatable, the study results confirm that this group of patients should be evaluated for the possibility of using anticoagulants.
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