Obstetric aspects of hereditary thrombophilias: epidemiology,complications and prophylaxis

The study gives a survey of literature on obstetric aspects of hereditary thrombophilias e.i. factor V Leiden, prothrombin gene 20210A mutation, antithrombin III deficiency, protein C/protein S deficiency, and hyperhomocysteinemia. All types of thrombophilia cause similar pathomorphological changes in placenta and decidua (high number of infarcts and microclots, decidual vasculopathia) as well as insufficient invasion of cytotrophoblast in spiral arteries. The study also discusses prophylactic rules: application of low molecular weight heparin and non-fractionated heparin in prophylaxis and in hyperhomocysteinemia application of folic acid.