In pregnancy, patients with thrombophilia are known to have a poorer obstetric outcome. However the outcomes of pregnancy are not well defined in the literature. We did a retrospective audit looking at a cohort of women with thrombophilia. Medical records were reviewed for pregnancy events pre and post diagnosis of thrombophilia, the management and pregnancy outcomes.
Twenty-nine women had a total of 125 pregnancies, 83 pre-diagnosis and 42 with treatment. They had a mean age of 34 years with mean age at diagnosis of 29 years old. Women treated after a diagnosis of thrombophilia had significantly less miscarriages in the 1st trimester and 2nd trimester (68% vs 21%, Fisher’s exact test P = <0.0001) than those pre-diagnosis and treatment.
The current treated pregnancy outcomes showed a mean birth weight of the babies born at term (37–40 weeks) was 3.2 kg (Range 2.43–3.95 kg). 38% had spontaneous onset of labour, whilst 55% were induced at 38–39 weeks gestation. The remaining 7% included a miscarriage and stillbirth. Only 63% achieved a vaginal delivery compared to 91.6% in the pre-diagnosis pregnancies, which was statistically significant. (P = <0.02 Fishers exact test). This is due to the higher number of inductions at 38–39 weeks gestation in these women.
Therefore the recommended treatment for thrombophilia in pregnancy has significant benefit to the outcome of live birth. However due to induction of labour prior to the due date to reduce the risk of stillbirth women are less likely to achieve a vaginal birth.
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