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Old 10-10-2008, 03:49 PM   #1 (permalink)
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Default Article: Thrombophilia & Miscarriage

Source: http://www.bellaonline.com/articles/art58716.asp/zzz

Content copyright © 2008 by Christine Beauchaine.

Thrombophilia & Miscarriage

Thrombophilia refers collectively to a condition which can cause excessive blood clotting. Thrombophilia can cause first and second trimester miscarriage by creating blood clots in the placenta and depriving the fetus of oxygen and vital nutrients. Thrombophilia is said to affect 5-8% of the population. In the general population who have thrombophilia, it can manifest itself either as deep vein thrombosis which is, as it sounds, is a blood clot in a vein (frequently the leg) or a pulmonary embolism which is a clot in the blood supply to the lung. Either of these can be serious or even life-threatening conditions. However, not all women who are at risk for thrombophilia experience either of these situations prior to having a miscarriage. Sometimes, recurrent miscarriages can by the first symptom of this problem.

Thrombophilia can be caused by a variety of different gene mutations. Common types of thrombophilia include Factor V Leiden, MTHFR mutation, and antiphospholipid antibodies which include anticardiolipin antibodies and lupus anticoagulants. People with thrombophilia can have either one copy of the genetic mutation or two. The first is called heterozygous. The second is referred to as homozygous. Women who have only one copy of the gene are considered at lower risk for developing problems than women who have two copies. These genetic muations can be inherited.

I tested positive for one copy of the MTHFR mutation. My doctors didn't think it was causing my losses but did try me one the Heparin/low-dose aspirin combination for my last pregnancy, as a precaution. Unfortunately, in my case, I had another miscarriage and the problem apparently was not related to thrombophilia. A person can also have thrombophilia due to an autoimmune disease.

The good news is that often these blood clotting issues can be treated in pregnancy by using the blood thinner Heparin and/or low dose aspirin to keep clots from forming in the blood. Unfortunately, testing is not usually performed on a woman until she suffers three or more pregnancy losses. So, if she's unaware that she has this condition, she may not be able to find out and therefore prevent further losses until she's already experienced several losses.

Not all of these thrombophilias have been proven to definitely cause miscarriage. Doctors disagree about which ones pose the most serious risks and indeed how much of a risk they pose. If you have ever experienced a blood clotting issue, you should tell your doctor before you get pregnant, if possible. If you've experienced multiple miscarriages, thrombophilia is one of the things they will likely test you for.
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Old 10-10-2008, 04:10 PM   #2 (permalink)
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Good post Meghan!!!

I also want to add that some clotting disorders come and go. I tested slightly positive for Lupus Anticoagulant, and at other times I tested negative.

In my last 3 pregnancies, I bled during the 1st trimester. With the first 2 of 3 pregnancies, I bled a lot, and the only thing that kept me from losing our DD was extensive bedrest. The following pregnancy, I wasn't able to be on such strict bedrest and lost that baby. With our last pregnancy, I tested positive just before my BFP and was put on Lovenox during week 5 and that helped save my boys.

I just wanted to put my story out there to try to help another cyster...
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Old 10-10-2008, 05:14 PM   #3 (permalink)
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Heidi - thank you for sharing your story!

Guess I should share mine too. Upshot: 3 losses in 7 months (one at week 10 after seeing a heartbeat, the others just after implantation), tested positive for the lupus anticoagulant and anticardiolipin antibodies...did baby aspirn and heparin in my next two pregnancies and now have 2 beautiful miracles - one boy, 33 months, and one girl, 10 months. I would never have had them if it weren't for the fact that I dared to question my first OB (who didn't know what to do with me) and asked for recurrent PG loss testing with my 2nd OB.

Miracles can and do happen.
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