Inherited thrombophilias & preg. outcome

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Re : Inherited thrombophilias & preg. outcome

Post by kara » Wed Dec 30, 2009 05:12 am

Beth I think we all get caught in that trap of wanting to "do" something - as long as we keep from blaming ourselves for doing something "wrong". I guess until they fully agree that thinners don't do any good - or are somehow harmful for us funky clotters, we'll just keep fingers crossed and follow our MFM's lead. I hope to have another one in the next year or so (baby, not thrombophilia), and as of 2 years ago I was told I'd be on lovenox too. Who knows now...when we get to that point.

Re : Inherited thrombophilias & preg. outcome

Post by beth11 » Wed Dec 30, 2009 04:32 am

Kara, yep, most are likely acquired, but they think the Protein S deficiency is inherited since my sister has tested positive for it, too. Ah well. As Caryn said, it seems like the science connecting thrombophilias with pregnancy complications is getting thinner and thinner, regardless. . . although, for my emotional well being I just have to tell myself that there's some connection since treating the thromphilias is the only thing I can "do" to help this pregnancy :)

Re : Inherited thrombophilias & preg. outcome

Post by caryn » Wed Dec 30, 2009 04:09 am

It's my understanding that the thrombophilias are generally not showing a strong significant statistical correlation with *any* pregnancy complications. Basically they thought they might -- there was a plausible physical mechanism and it seemed possible in some of the smaller studies -- but careful checking is gradually demolishing the possibility.

Here's [url="http://www.preeclampsia.org/forum/viewtopic.php?t=37675"]a bit more discussion[/url].

Re : Inherited thrombophilias & preg. outcome

Post by kara » Wed Dec 30, 2009 03:02 am

Beth, your antiphospholipids are likely acquired unless you have a family history of them....in which case they *could* be inherited. Did you retest the antiphospholipids before your current pregnancy?

I also noted on my last blood results that my Antithrombin was below normal, but my doc didn't say anything about it. Lots to ask the MFM's about.

Re : Inherited thrombophilias & preg. outcome

Post by beth11 » Wed Dec 30, 2009 01:41 am

Kara, Although he kind of skimmed over it, I noticed that too and found it very interesting. Especially since my MFM is so focused on my Protein S deficiency, which I understand is inherited.

Re : Inherited thrombophilias & preg. outcome

Post by jmom08 » Tue Dec 29, 2009 11:37 am

Definitely interesting! From the little research I've done on mine (protein C deficiency), it's inherited -- I wonder if that means my sister & cousins can breathe easier about their own risks? If I'm understanding that right?

Re : Inherited thrombophilias & preg. outcome

Post by kara » Tue Dec 29, 2009 09:14 am

Very interesting. One of the Medical Board Panelists spoke about this at the Patient Symposium and basically said the same thing, that the inherited thrombophilia's were less significant in pregnancy outcomes. Now I need to hear more about the Acquired thrombophilia's.

Inherited thrombophilias & preg. outcome

Post by caryn » Tue Dec 29, 2009 09:01 am

Prothrombin gene mutation confers an increased risk for the development of adverse pregnancy outcomes in otherwise asymptomatic, nulliparous women, whereas homozygosity for MTHFR 1298 may protect against these complications. The majority of asymptomatic women who carry an inherited thrombophilia polymorphism have a successful pregnancy outcome...

http://www.ncbi.nlm.nih.gov/pubmed/20027027

So the only thrombophilias that popped up as statistically significant in this analysis were prothrombin -- which made your pregnancy odds worse -- and MTHFR 1298 -- which made your odds better.

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