Retrospective Analysis of Hereditary Thrombophilias Outcomes in Pregnancy – Single Institution Experience

Abstract

Hereditary thrombophilia introduces a layer of complexity to pregnancy, increasing the risk of serious complications and representing diagnostical and therapeutical challenge. 
Materials and methods: Retrospective analysis of medical databases from Department of Gynecology and Obstetrics, Institute of Transfusion Medicine and Clinical Department of Pathology and Forensic Medicine, University Hospital Center Osijek consisting of 92 pregnancy cases. Initiation of theraphy with low-molecular-weight heparine started according to evaluation of medical history and genetic risk in I.,II. and III. trimester of pregnancy (33%, 26% and 41%). Data were made from classification of analysed sample (0- as normal value, 1- as unfavorable value, 2- as extremely unfavorable value).
Results: According to listed classification in observed sample 75% had normal outcome, 23% had unfavorable outcome and 2% had extremely unfavorable outcome. Analysed placenta was normal in 68%, unfavorable in 21% and extremely unfavorable in 11% of pregnancies. 
The indication for genetic testing based on positive family history of thromboembolic incidents was set to 31.28% and obstetric history was significant in 58.28% of pregnant women. In 62.42% of pregnant women resulting in normal outcome, 18.49% adverse outcome while 10.98% resulted in miscarriage or fetal death. The likelihood of adverse outcomes of pregnancy is almost the same in the group of pregnant women who received LMWH during pregnancy as in the group without therapy (OR = 1.16, 95% CI 0.59-2.30, P = 0.65). 
Conclusion: with careful risk assessment, individualized management plans, and close monitoring, the majority of women with these conditions can achieve a successful pregnancy outcome.