Last updated January 13, 2022

Inherited Thrombophilias in Pregnancy

Summary of Recommendations

The following recommendations are based on limited or inconsistent scientific evidence.

  • Screening for inherited thrombophilias is not recommended for women with a history of fetal loss or adverse pregnancy outcomes including abruption, preeclampsia, or fetal growth restriction because there is insufficient clinical evidence that ante-partum prophylaxis with unfractionated heparin or low-molecular-weight heparin prevents recurrence in these patients.
  • Because of the lack of association between either heterozygosity or homozygosity for the MTHFR C677T polymorphism and any negative pregnancy outcomes, including any increased risk of VTE, screening with either MTHFR mutation analyses or fasting homocysteine levels is not recommended.
  • Warfarin, low-molecular-weight heparin, and un-fractionated heparin do not accumulate in breast milk and do not induce an anticoagulant effect in the infant. Therefore, these anticoagulants may be used in women who breastfeed.
( B )
574

The following recommendations are based primarily on consensus and expert opinion.

  • Among women with personal histories of VTE, recommended screening tests for inherited throm-bophilias should include factor V Leiden mutation; prothrombin G20210A mutation; and antithrombin, protein S, and protein C deficiencies.
  • All patients with inherited thrombophilias should undergo individualized risk assessment, which may modify management decisions regarding VTE evention.
(C)
574

Recommendation Grading

Overview

Title

Inherited Thrombophilias in Pregnancy

Authoring Organization

Publication Month/Year

July 1, 2018

Document Type

Consensus

External Publication Status

Published

Country of Publication

US

Inclusion Criteria

Female, Adolescent, Adult

Health Care Settings

Ambulatory

Intended Users

Physician, nurse midwife, nurse

Scope

Assessment and screening, Prevention, Management

Diseases/Conditions (MeSH)

D019851 - Thrombophilia

Keywords

pregnancy, thrombophilia, inherited thrombophilias