Thrombophilias in pregnancy and their role in preeclampsia

Thrombophilias are inherited or acquired conditions that predispose the affected individual to thromboembolism. Several studies have demonstrated that the presence of thrombophilic defects is a risk factor for adverse pregnancy outcome. Preeclampsia (PE) is associated with vascular and endothelial damage and thrombophilias may play an important role in this pathology. Most studies have found an association between early-onset PE and thrombophilia. Early recognition of PE is essential for optimal treatment but, at present, specific markers of the disease are lacking. Therapy must address the prevention of maternal complications and improvement of neonatal outcome. There is no clear evidence to support the use of heparin prophylaxis for PE. A high dose of antithrombin concentrate may represent a possible therapy in early-onset PE. Preventive and conservative treatment of PE with early diagnosis and a new therapeutic approach will allow the prolongation of pregnancy with fewer maternal and fetal complications.