Use

Thrombophilias contribute to a number of pregnancy complications, including fetal loss, placental abruption, and poor fetal growth.6 It has been estimated that thromboembolism complicates approximately one in 1600 births in the US.6 Pregnancy is associated with increased clotting potential, decreased anticoagulant activity, and decreased fibrinolysis. The risk for thrombosis is further exacerbated by venous stasis in the lower extremities due to compression of the inferior vena cava and the pelvic veins by the enlarging uterus, a hormone-mediated increase in venous capacitance, insulin resistance, and hyperlipidemia.6 While there is a strong association between inherited thrombophilias and venous thromboembolism, its role as a cause of adverse pregnancy outcomes, such as fetal loss, preëclampsia, and fetal growth restriction, is not as well defined. A recent American Congress of Obstetricians and Gynecologists (ACOG) practice bulletin made recommendations as to the appropriate use of laboratory tests for inherited thrombophilias of pregnancy.6 This publication also listed the risks of thrombosis associated with a number of inherited thrombophilias, both in pregnant women with and without a history of previous thrombosis.