Thrombophilia doesn't affect preeclampsia rate in after that pregnancies

Women who have preeclampsia surrounded by their first pregnancy are less feasible to experience it in subsequent pregnancies even if thrombophilia develops, Dr. Birgit Arabin reported at the 20th European Congress of Perinatal Medicine.

The concept of screening for thrombophilia in pregnant women beside preeclampsia has be controversial, especially in feathery of the fact that a systematic review (Eur. J. Obstet. Gynecol. Reprod. Biol. 2002;101:6-14) and a metaanalysis (Cochrane Database Syst. Rev. 2003;2:CD003580) hold not recommend screening until it is shown that interventions such as heparin and/or low-dose aspirin are effective surrounded by improving outcomes, said Dr. Arabin of the Clara Angela Foundation, Witten, Germany.

To determine if thrombophilia have any impact on the rate of preeclampsia in women who own more than one pregnancy, Dr. Arabin and her colleagues examined 426 Dutch women who had preeclampsia during their first pregnancy in 1995-2005. Among the 163 (38%) women who have thrombophilia during their first pregnancy, the 40% rate of preeclampsia occurring before 32 weeks (109 women) be similar to the 35% rate of preeclampsia occurring after 32 weeks (54 women).

At least one subsequent pregnancy occur in 252 of the 426 women near preeclampsia. Of those 252, 96 had at tiniest one episode of thrombophilia and were treated near the low-molecular-weight heparin dalteparin (Fragmin) and low-dose aspirin; the remaining 156 without thrombophilia received treatment next to low-dose aspirin. In these pregnancies, 40 (16%) of the 252 women developed preeclampsia, but the rate was not significantly different between women beside (17%, 16 of 96) and those without (15%, 24 of 156) thrombophilia. The 40 mothers who have preeclampsia in their first subsequent pregnancy give birth to infants with significantly elder gestational age and significantly higher birth weightiness than infants who were born to the 252 mothers who have preeclampsia in their first pregnancy.

Preeclampsia reoccurred surrounded by only 7 (9%) of the 74 women who have a second subsequent pregnancy. The rate of preeclampsia was similar among the women near (3 of 37) and without (4 of 37) thrombophilia.

None of the 15 women who have a third subsequent pregnancy developed preeclampsia.

"It seems approaching the more pregnancies you have, the smaller number chance you'll catch recurrent preeclampsia; thrombophilia does not play a role contained by this process," said Dr. Arabin, also of the department of perinatology at the Isala Clinics, Zwolle, the Netherlands.

The Dutch FRUIT study (Fragmin in Pregnant Women With a History of Uteroplacental Insufficiency and Thrombophilia) is currently enrolling patients to determine whether a combination of dalteparin and low-dose aspirin reduce the rate of preeclampsia before a gestational age of 34 weeks more than low-dose aspirin alone, Dr. Arabin noted.