Thrombophilias & Recurrent Miscarriage

Thrombophilias are a group of clotting disorders that predispose individuals to inappropriate blood clot formation. These disorders can lead to health problems and recurrent miscarriage.

Thrombophilias increase the risk of developing thromboembolism, or blood clots. These clots block the blood vessels throughout the body. If the clots travel to the brain, they can lead to stroke. Those that move to the lung results in a pulmonary embolism.

In women who are pregnant, thrombophilias can cause pregnancy complications or loss including:

First-trimester miscarriage
Stillbirth
Placental abruption (a condition where the placenta pulls away from the uterine wall)
Preeclampsia
Fetal growth problems

These conditions occur when blood clots develop obstructing blood vessels in the placenta and interfering with blood flow to the fetus.

During normal pregnancy, even women without thrombophilia are more likely to develop a venous thrombosis (blood clot in the leg) because of the changes that take place in the blood clotting system that help to prevent severe blood loss during childbirth.

TYPES OF THROMBOPHILIAS

Thrombophilias can be acquired or inherited. Acquired thrombophilias may be associated with certain medical conditions that cause hypercoagulability of the blood, such as sickle cell anemia, cancer, inflammation or diabetes.

Antiphospholipid syndrome (APS) is an autoimmune system disorder linked to excessive clotting of the blood. In those who suffer from autoimmune disorders, the body cannot distinguish between normal tissues and harmful bacteria, viruses, toxics and other foreign substances. It responds by attacking its own healthy tissue. Women who test positive for antiphospholipid antibodies (APLA) have been shown to be at risk for developing blood clots in both the veins and arteries.

INHERITED THROMBOPHILIAS

Those with genetic or hereditary thrombophilias have a predisposition to blood clotting and are at a greater risk of developing blood clots in veins throughout the body. These conditions also increase the risk of miscarriage or other pregnancy complications such as miscarriage, poor fetal growth, and fetal loss.

INHERITED THROMBOPHILIAS INCLUDE THE FOLLOWING:

Factor V Leiden Mutation – the most common of the inherited thrombophilias those with this condition have a resistance to the action of activated protein C
Prothrombin G20210A Mutation – this mutation of this particular gene leads to increased levels of plasma prothrombin, increasing the risk of venous thromboembolism
Antithrombin deficiency – this rare condition blocks clotting factors impacting coagulation and increasing the chance of developing blood clots
Protein S/Protein C deficiency – rare inherited thrombophilias caused by too little-activated protein C or protein S

LINK BETWEEN THROMBOPHILIA & RECURRENT MISCARRIAGE

There is evidence to support a link between APLAs and recurrent fetal loss less than ten weeks.

Women with congenital or acquired antithrombin deficiency are at extremely high risk for developing clots during pregnancy or after delivery. Without treatment, the risk of pregnancy loss is also slightly increased and is usually due to blood clots that develop in the placenta, depriving the fetus of blood and oxygen.

MANAGING THROMBOPHILIA IN PREGNANCY

Heparin (a medication that helps to prevent the formation of blood clots) injections may be recommended for pregnant women diagnosed with antithrombin deficiency due to the increased risk of miscarriage.

A low-dose aspirin regimen may also be prescribed during pregnancy and for a few weeks after delivery.

A carefully prescribed treatment regimen can reduce the risk of miscarriage and other pregnancy complications.

Contact your local URA clinic in Hasbrouck Heights, Hoboken, and Wayne, NJ for more information. Your friendly URA team will be happy to provide more details on thrombophilias and discuss treatment options.