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Trombofilie en zwangerschap

  • Perinatologie
  • Published:
Tijdschrift voor kindergeneeskunde

Summary

Inherited thrombophilia defines a group of disorders associated with an increased tendency to develop thrombosis. Pregnancy is an acquired state of hypercoaguability, therefore, thrombophilias become often clinically manifest (as thrombosis) during pregnancy. It is also suggested to be associated with poor pregnancy outcome. Therefore, the pediatrician who is confronted with the neonate/child from a mother with an increased risk for thrombosis has to be aware of thrombophilia. Women considered at very high risk of venous thromboembolism include those with antithrombin deficiencies, homozygous for factor V Leiden mutation and/or prothrombin mutation. Women with a personal or family history of thrombosis should be offered thrombophilia counseling and testing. The validity of other indications unique to pregnancy is presently less clear. As the results of these relatively small poorly controlled studies are often conflicting, the routine screening of women with poor pregnancy outcome including (severe) preeclampsia and intrauterine fetal death is not recommended and should be reserved for research purposes.

Samenvatting

Trombofilie is gedefinieerd als familiair voorkomende defecten die een verhoogde neiging voor trombose veroorzaken. In de normale zwangerschap is er een verworven, verhoogd risico op veneuze trombose. Er zijn studies die een associatie suggereren tussen stollingsafwijkingen en zwangerschapscomplicaties zoals pre-eclampsie en intra-uteriene groeivertraging. Het is daarom van belang dat de kinderarts die geconfronteerd wordt met een moeder met een verhoogd risico voor trombose op de hoogte is van trombofilie. Aan vrouwen met een trombose in de voorgeschiedenis en/of vrouwen met trombose bij eerstegraads verwanten wordt trombofilie-counseling en screening geadviseerd. Andere indicaties met betrekking tot de zwangerschap zijn minder evident. Door het ontbreken van grote onderzoeken met duidelijke resultaten zijn wij niet voor het routinematig screenen op trombofilie van vrouwen met zwangerschapscomplicaties in de voorgeschiedenis. Naar onze mening is trombofilieonderzoek in deze groep op dit moment uitsluitend verantwoord binnen het kader van wetenschappelijk onderzoek.

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  1. www.bsl.nl/shop/tydschrift-vkindergeneeskunde-0376-7442.html

    C. J. M. de Groot

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  1. C. J. M. de Groot
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  2. A. Franx
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  3. E. A. P. Steegers
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Correspondence to C. J. M. de Groot.

Additional information

Mw. dr. C.J.M. de Groot, dr. A. Franx, prof. dr. E.A.P. Steegers, afdeling Verloskunde en Vrouwenziekten, Erasmus mc, Rotterdam.

Correspondentieadres: Dr. C.J.M. de Groot, afdeling Verloskunde en Vrouwenziekten, Erasmus MC, Sophia Kinderziekenhuis, 4130, Dr. Molewaterplein 50, 3015 GE Rotterdam, tel: 010-4633632, fax: 010-4636815

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de Groot, C.J.M., Franx, A. & Steegers, E.A.P. Trombofilie en zwangerschap. KIND 73, 130–135 (2005). https://doi.org/10.1007/BF03061561

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