Thrombophilia and adverse pregnancy outcome

Congenital and acquired thrombophilias are the most common predisposing fac tors for thromboembolism, but they may also con tribute to pathophysiologic al processes involved in recurrent pregnancy loss, fetal death, intrauterin e growth restriction, placental abruption, placental infarction, and pre-ec lampsia. The most common thrombophilias are deficiencies of antithrombin II I, protein C, and protein S, acquired protein C resistance, genetic mutatio n encoding for factor V Leiden, prothrombin gene, and inherited hyperhomocy steinemia, and antiphospholipid syndrome. Although adverse pregnancy outcom es are more common in women with thrombophilia, the current evidence does n ot support routine thrombophilia screening of all pregnant women. Selective thrombophilia screening may be justified in certain group of women, partic ularly those with a history of thromboembolism. More research is required t o confirm or refute the causal link between thrombophilia and abnormal plac entation, and assess effectiveness and safety of thromboprophylaxis in preg nant women.