Thrombophilia & Women's Health, An Issue of Obstetrics and Gynecology Clinics (The Clinics: Internal Medicine)

Cover......Page 1
Foreword......Page 2
Preface......Page 4
Thrombophilia and Women’s Health: An Overview......Page 6
Acquired versus inherited thrombophilias......Page 7
Venous versus arterial thrombosis......Page 8
Frequency of thrombophilic factors in different populations......Page 9
Causality......Page 10
Coherence and biological plausibility......Page 11
Screening......Page 12
The false-positive case......Page 13
References......Page 14
General considerations......Page 16
Classification, pathophysiology, and prevalence of inherited thrombophilia......Page 17
Inherited thrombophilia and the risk for venous thromboembolism......Page 20
Inherited thrombophilia and pregnancy-associated complications......Page 22
Asymptomatic individuals who have thrombophilia......Page 25
Patients who have thrombophilia and a history of venous thromboembolism......Page 26
Summary......Page 28
References......Page 29
Antiphospholipid antibody syndrome......Page 34
Hyperhomocystinemia......Page 40
Other acquired thrombophilic states......Page 42
References......Page 43
Screening for Thrombophilia......Page 48
Family history......Page 49
Why perform thrombophilic tests?......Page 50
Why not perform thrombophilia screening?......Page 51
What is the most economical way for screening for inherited thrombophilia?......Page 52
References......Page 53
Monitoring the Effects and Managing the Side Effects of Anticoagulation during Pregnancy......Page 55
Vitamin K antagonists......Page 56
Unfractionated heparin......Page 59
Low-molecular-weight heparins......Page 60
Managing the side effects of heparins during pregnancy......Page 61
Management of bleeding complications......Page 63
Management of skin allergic reactions......Page 64
Management of heparin-induced thrombocytopenia......Page 65
Summary......Page 66
References......Page 67
Thrombophilia and the Risk for Venous Thromboembolism during Pregnancy, Delivery, and Puerperium......Page 70
Hereditary thrombophilia......Page 71
Inherited thrombophilia and the risk for venous thromboembolism in pregnancy......Page 72
Risk factors for venous thromboembolism in pregnancy other than inherited thrombophilia......Page 75
Screening for inherited thrombophilia in pregnancy......Page 76
Thromboprophylaxis and inherited thrombophilia in pregnancy......Page 78
References......Page 82
Thrombophilia and Recurrent Pregnancy Loss......Page 85
Prevalence......Page 86
Subsequent pregnancies......Page 87
Placental changes......Page 88
Cytokines......Page 89
Hormones and thrombosis......Page 91
Treatment......Page 92
Summary......Page 93
References......Page 94
Hemostatic changes in pregnancy......Page 99
Thrombophilia and fetal loss......Page 100
Thrombophilia and intrauterine growth restriction......Page 103
Thrombophilia and pre-eclampsia......Page 104
Hyperhomocysteinemia and MTHFR 677......Page 105
Inherited thrombophilias and abruptio placentae......Page 106
Monitoring of low molecular-weight heparin therapy......Page 107
Future perspectives......Page 108
References......Page 109
Fetal and Neonatal Thrombophilia......Page 113
Perinatal arterial stroke and cerebral palsy......Page 114
Cerebral sinus venous thrombosis......Page 115
Renal vein thrombosis......Page 116
Other neonatal complications......Page 117
References......Page 118
Effects of contraceptive or hormone replacement therapy on hemostasis......Page 123
Oral contraceptives and venous thrombosis......Page 124
Venous thrombosis risk in oral contraceptive users who have additional risk factors......Page 125
Oral contraceptives and the risk for arterial thrombosis......Page 126
Hormone replacement therapy and the risk for venous thrombosis......Page 127
Hormone replacement therapy and arterial disease......Page 128
References......Page 129
Hemostatic changes during normal pregnancy and the risk of thrombosis......Page 136
The use of warfarin throughout pregnancy......Page 137
Can subcutaneous unfractionated heparin be substituted for warfarin?......Page 138
The controversy over low-molecular-weight heparin......Page 139
Low-molecular-weight heparin in pregnant women who have prosthetic heart valves......Page 140
Current guidelines: European Society of Cardiology and American College of Cardiology/American Heart Association......Page 141
Recent updates......Page 142
References......Page 143
Low-molecular-weight heparin......Page 147
Induction of labor versus expectant management......Page 148
Regional analgesia......Page 149
References......Page 150
The Seventh American College of Chest Physicians Guidelines for the Antenatal and Peripartum Management of Thrombophilia: A Tutorial......Page 152
Example 2......Page 153
Comment......Page 154
Example 1......Page 155
Comment......Page 156
Comment......Page 157
Reference......Page 158