如何正确看待复发性流产中的易栓因素

易栓症是复发性流产多种病因中的一类。易栓症包括获得性易栓症(即抗磷脂综合征)和遗传性易栓症。抗磷脂综合征是目前唯一得到广泛认可、与复发性流产明确相关的易栓因素,但是其诊断应满足相应的分类标准及标准外定义,治疗应遵从循证医学证据及指南。现有证据不足以证实遗传性易栓症与不良妊娠结局的相关性,不建议在既往不良孕产史的患者中常规检测抗凝蛋白活性。对于明确诊断的遗传性易栓症患者,妊娠期间抗凝的目的是预防血栓形成。血小板聚集率与复发性流产的相关性目前尚不明确。

Role of thrombophilia in recurrent pregnancy loss

Thrombophilia is one of the various etiologies of recurrent pregnancy loss(RPL),which includes acquired thrombophilia(usually indicated as antiphospholipid syndrome,APS)and inherited thrombophilia.Only APS is well recognized and proved to be related with RPL.The diagnosis of APS should be strictly based on the classification criteria and non-criteria definition.The further therapy should follow the evidence-based medicine and recommendations.Till now,the association between inherited thrombophilia and fetal loss has not been confirmed.Routine testing of women with RPL for inherited thrombophilia is not currently recommended.For a woman with inherited thrombophilia,the anticoagulant treatment is to prevent thrombosis during the pregnancy.Moreover,the correlation between platelet reactivity and RPL is not clear currently.