Hereditary thrombophilia and pregnancy: tests, possible complications, advice

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

Every woman, before planning a pregnancy, should conduct an examination of her body in order to determine possible risks. The fact is that this is caused by a certain need and its name is thrombophilia. This disease was identified not so long ago and therefore many doctors are still studying pathology. However, it is safe to say that the two concepts of hereditary thrombophilia and pregnancy do not go well together. Not only the expectant mother, but also her child is in serious danger.

With such a disease during pregnancy, the body's strength is noticeably weakened, due to which the ability of the immune system to withstand internal dangers is seriously reduced. But how big is the threat from such a disease? What kinddiagnostic methods used by modern medicine? And is it even possible to plan a pregnancy in this case?

What is thrombophilia?

The term "thrombophilia" should be understood as a pathological condition of the body, when there is a high probability of blood clots. Under normal conditions, both circulatory mechanisms (clotting and anti-clotting) are in a balanced state.

A disappointing diagnosis can be made in the course of finding a debilitating factor in one of the systems. As a rule, at an early stage of development, the disease does not manifest itself in any way and can be detected by pure chance. These are injuries during surgery, including the detection of hereditary thrombophilia during pregnancy.

Tellingly, one of the features of pregnancy is the increased clotting of plasma in order to potentially prevent blood loss during childbirth, as well as the likelihood of placental abruption and loss of a child. Due to increased blood clotting, there is already a risk of blood clots.

Risk factors

It is worth noting that the very fact that a woman has a disease gene is not yet a 100% guarantee that she will definitely encounter thrombophilia if she plans to become pregnant. Much here depends on a number of provoking factors:

• Pregnancy at age 35 or older.
• Being obese.
• Diseases of the liver, cardiovascular system.
• Active smoking (10 or more cigarettes per day).
• Varicoseven.
• High number of pregnancy attempts.
• Prolonged course of diseases at the chronic stage.
• Staying in the same position for a long time.
• Use of hormonal birth control.
• Frequent headaches.

As a number of reviews show, pregnancy with hereditary thrombophilia worries many women. In addition, when exposed to any of these factors, the risk of complications during the period of bearing a child increases significantly.

For this reason, it is necessary to identify the characteristic signs of the disease in a timely manner and begin a course of treatment. In this case, it will be possible not only to avoid the consequences, but also to save the child.

Danger of disease

What is the risk of thrombophilia in the body of a pregnant woman? In most cases, genetic thrombophilia first makes itself felt during pregnancy. This is largely due to the appearance of the third placental circle of blood circulation. As a result, the entire circulatory system is under severe strain.

Typically, there are no capillaries in the placenta at all - the maternal plasma immediately enters this organ, where it flows between the chorionic villi and only then enters the umbilical cord.

As a rule, the disease does not pose a serious threat to a woman, but only until the moment of conception, when everything changes dramatically. The risk of developing the consequences of hereditary thrombophilia during pregnancy increases by 5 or 6 times. And the main dangerdisease lies in the likelihood of miscarriage. And he, in the presence of thrombophilia, can happen both in the first and in the last trimester. If a woman was able to bear her child, then childbirth, as a rule, occurs a little earlier than expected. Usually this is between 35 and 37 weeks, but this scenario can still be considered favorable.

Serious consequences for the child

The formation of blood clots in the vessels of the placenta can cause its insufficiency. In turn, because of this, there may be a delay in the development of the child. In addition, a high probability of oxygen starvation in the fetus (hypoxia) cannot be ruled out. In this case, the baby's body will be supplied with less and less nutrients, or they will completely stop coming. Ultimately, everything can end in disappointing complications of hereditary thrombophilia during pregnancy. The consequences for the child may be of the following nature:

• placental abruption;
• malformations;
• pregnancy fading;
• miscarriage;
• preterm birth;
• stillbirth.

As many experts note, complications begin to appear no earlier than the 10th week of pregnancy. There is no data regarding the negative impact of thrombophilia on the bearing of a child before this period.

At the same time, the second trimester with such a disease proceeds calmly. But after 30 weeks, the risks are already increasing - just during this period, fetoplacental insufficiency and severe forms may begin to develop.preeclampsia.

Diagnosis of disease

Unfortunately, it is quite difficult to diagnose thrombophilia, since the symptoms of the disease are similar to the characteristic signs of varicose veins. Usually it is heaviness and pain in the legs, fatigue. At the same time, it makes no sense to conduct a survey of all pregnant women, since hereditary thrombophilia during pregnancy can occur only in 0.1-0.5% of expectant mothers.

In this regard, women can learn about their diagnosis from a qualified specialist who leads the pregnancy throughout the term. For this reason, all potential mothers should responsibly choose a good gynecologist.

What can alert doctors?

What makes a specialist think that there is a risk of developing thrombophilia? This can usually be indicated by a number of factors:

• Miscarriage. Usually, this should be understood as unsuccessful pregnancies (2 or 3, or even more), which did not end in childbirth. This should also include the fading of the development of the child, miscarriages, premature birth, death of the child.
• Complications of a previous pregnancy: fetoplacental insufficiency and placental abruption, severe forms of preeclampsia.
• Formation of blood clots while taking hormonal contraceptives.
• Development of thrombophilia in a woman's relatives.
• Failed IVF attempts.

If the doctor identifies at least one of the above factors, this is already a reason for a more serious examination.

Planning pregnancy withhereditary thrombophilia

The presence of such a disease as thrombophilia, in which the processes of hemostasis are seriously impaired, is not yet a final verdict and in no case is a contraindication to pregnancy. The only thing to consider for women who have been diagnosed with this is to remember that they are at risk. In this regard, you need to be as attentive to yourself as possible.

In addition, it is necessary to plan this event in advance and, if necessary, start timely treatment. This requires some research. And if the fact of the development of thrombophilia is detected, the doctor will prescribe the necessary medications:

• anticoagulants;
• low molecular weight (fractionated) heparin;
• folic acid;
• B vitamins;
• antiplatelet inhibitors (they prevent blood clots);
• polyunsaturated fatty acids (omega-3);
• micronized progesterone.

When the fact of the presence of hereditary thrombophilia before pregnancy is confirmed, women should not panic and even more so deny themselves the joy of motherhood. The very fact that the disease was detected even before the onset of pregnancy is already good. Knowing your position, you can competently prepare for the upcoming bearing of a child. And to avoid many undesirable consequences.

Required research for pregnant women

Pregnant women diagnosedthrombophilia is confirmed on the basis of examination data. At the same time, they need to donate blood for analysis twice. For the first time, the study is being conducted as part of a screening. As a rule, the localization of the pathology of the coagulation system can be detected with such an analysis.

For the second time, the woman will have to undergo specific studies for a more accurate diagnosis. Similar tests for thrombophilia during pregnancy can detect specific disorders that are characteristic of this disease:

• increase in plasma density;
• increase in the number of platelets and red blood cells;
• disbalance between blood cells;
• decrease in erythrocyte sedimentation rate.

After identifying these signs, the pregnant woman is referred to a narrow-profile specialist - a hematologist.

He usually orders more specific tests that include a series of tests:

• Activated partial thromboplastin time (APTT) - allows you to detect the activity of provocateurs acting on plasma coagulation.
• Thrombin time, or TV test, is the amount of time it takes for a blood clot to form.
• Prothrombin index - an indicator of blood plasma coagulation.
• The presence of a specific protein and antiphospholipid bodies - they are able to destroy cell membranes.

In addition, to determine the significant risk factors for genetic thrombophilia during pregnancy, appropriateexaminations that reveal disorders at the cellular level.

Drug therapy

The course of therapy will largely depend on the severity, form of the disease, gestational age. Moreover, it is necessary to start treatment at the stage of pregnancy planning or at its early stage. At the same time, it should be borne in mind that the genetic form of the disease is different in that it is impossible to achieve a full recovery

However, taking medication will stabilize the condition of the pregnant patient. At the same time, replacement therapy will provide the body with the missing elements for blood clotting. For this purpose, injections are carried out using the necessary drugs or droppers are made.

Treatment of hereditary thrombophilia during pregnancy is aimed at eliminating the maximum number of blood clots. In this case, the duration of the course can be 2-4 weeks. In some cases, women need lifelong medication.

A few days before delivery, the use of drugs is canceled. If the process proceeds naturally, then the woman is hospitalized. This is to monitor her condition after she is scheduled to stop taking her medications.

3 days after the completion of the course of drug therapy, a pregnant woman must pass all the necessary tests. With an increase in the main indicators of plasma and urine, doctors make a responsible decision about artificial childbirth. Of course, while acceptingnote all possible risks.

Blood transfusion for thrombophilia during pregnancy

This is another method of treating thrombophilia when planning a pregnancy. If the pathological condition proceeds in a mild form, the woman is given intravenous lyophilized blood plasma or donor raw materials in dry form. In the severe stage of thrombophilia, fibrinolytic drugs are connected. Injections are carried out in those places where, in fact, there was a blockage of the blood vessel.

Helpful tips

Women who are undergoing treatment for thrombophilia are highly discouraged from being in one position for a long time. However, long walks should also not be carried out! In addition, heavy lifting should be avoided!

In order to increase the effectiveness of treatment, as well as to avoid the consequences of hereditary thrombophilia, a number of useful tips from specialists should be followed during pregnancy:

• You can perform self-massage of affected organs.
• Don't stop taking prescribed medications.
• Take short walks.
• Adhere strictly to the diet prescribed by the doctor.
• Stay work-life balance.
• Therapeutic exercise will only benefit.

If a woman led an inactive lifestyle before the development of the disease, now is the time for significant changes. It is worth moving more, and for pregnant women there are whole complexes of he alth-improving gymnastics.

As a conclusion

Finally worth moretimes to give guidance to all women who wish to have a child, but the diagnosis of thrombophilia somewhat overshadows the mood. Desperate is clearly not worth it! Despite the fact that hereditary thrombophilia and pregnancy are two incompatible concepts, many patients have carried and safely given birth to completely he althy children.

Of course, it is necessary to strictly follow all the recommendations of the attending physicians. After all, three narrowly focused specialists take part in therapy at once:

• gynecologist;
• hematologist;
• geneticist.

This is due to the fact that therapy requires an integrated approach. In addition, any pregnant woman should be responsible not only for her own well-being, but also for the life of her unborn child. For this, it is just necessary to appear to the specialists mentioned above.