Early pregnancy losses are common amongst healthy women. Current guidelines do not support the routine screening of women with early or recurrent pregnancy loss for inherited thrombophilias. Moreover, there are recommendations against instituting thromboprophylaxis (LMWH) in women with inherited thrombophilias wishing to achieve a successful term pregnancy. By performing testing for inherited thrombophilias, patients may be unnecessarily exposed to the harms of thromboprophylaxis, inappropriately labeled with a disease-state, and may unnecessarily modify future plans for travel, pregnancy or surgery based on detection of an “asymptomatic” thrombophilia. Lastly, patients with negative testing may receive false reassurance.
Sources:
Middeldorp S, et al. American Society of Hematology 2023 guidelines for management of venous thromboembolism: thrombophilia testing. Blood Adv. 2023 Nov 28;7(22):7101-7138. PMID: 37195076.
Quenby S, et al. Heparin for women with recurrent miscarriage and inherited thrombophilia (ALIFE2): an international open-label, randomised controlled trial. Lancet. 2023 Jul 1;402(10395):54-61. Epub 2023 Jun 1. PMID: 37271152.
Skeith L, et al. A meta-analysis of low-molecular-weight heparin to prevent pregnancy loss in women with inherited thrombophilia. Blood. 2016 Mar 31;127(13):1650-5. Epub 2016 Feb 2. PMID: 26837697.