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Peripartum management of hereditary thrombophilia: results of primary surveillance in Japan

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Abstract

This study investigated patients with thrombophilia and current peripartum management practices based on national surveillance in Japan. Between 2014 and 2018, antithrombin (AT), protein C (PC) and protein S (PS) deficiency were observed in 84, 67, and 443 pregnancies, respectively, with incidence rates among total deliveries at 0.012%, 0.009%, and 0.061%. The percentage of institutions that measured both antigens and AT, PC, and PS activity for the diagnosis of thrombophilia was 50.2%, and 46.9% of institutions did not perform gene analysis. Prophylactic anticoagulation therapy was used in the ante- and postpartum management of patients with AT deficiency at 67.1% and 66.3% of institutions, most commonly with 10,000 units of unfractionated heparin. Ante- and postpartum management of PC and PS deficiency was performed at 75.3% and 67.1% of institutions. Approximately half of the institutions performed peripartum prophylactic AT supplementation for AT deficiency. Low trough AT activity before supplementation was most commonly 50 ≤  < 70%, and the highest AT supplementation was 1500 ≤  < 3000 units. The number of pregnancies with AT, PC and PS deficiency might be as many as 29, 23 and 151 every year in Japan if complete answers were provided.

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Abbreviations

AT:

Antithrombin

DVT:

Deep vein thrombosis

FV:

Factor V

JSOG:

Japan Society of Obstetrics and Gynecology

LDA:

Low dose aspirin

LMWH:

Low molecular weight heparin

PC:

Protein C

PE:

Pulmonary embolism

PS:

Protein S

UFH:

Unfractionated heparin

VTE:

Venous thromboembolism

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Acknowledgements

This work was supported by the Research Grants of the Ministry of Health, Labour and Welfare Science of Japan for Blood Coagulation Abnormalities in the Research Program on Rare and Intractable Diseases.

Author information

Author notes

  1. Co-first author: Takao Kobayashi and Kazuko Sugiura.

  2. Contributed equally to this work with: Takao Kobayashi and Kazuko Sugiura.

Authors and Affiliations

  1. Director Emeritus, Department of Obstetrics and Gynecology, Hamamatsu Medical Center, 328 Tomitsuka-cho, Naka-ku, Hamamatsu, Shizuoka, 432-8580, Japan

    Takao Kobayashi & Kyuya Hirai

  2. Department of Reproductive Health Nursing/Midwifery, Nagoya City University Graduate School of Nursing, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan

    Kazuko Sugiura

  3. Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan

    Toshiyuki Ojima

  4. Department of Laboratory Sciences, College of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan

    Eriko Morishita

Authors
  1. Takao Kobayashi
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  2. Kazuko Sugiura
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Contributions

TK wrote the manuscript and researched data. KS collected paper surveillance questionnaire and researched data. TO, KH, and EM contributed to the discussion and reviewed or edited the manuscript.

Corresponding author

Correspondence to Takao Kobayashi.

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Kobayashi, T., Sugiura, K., Ojima, T. et al. Peripartum management of hereditary thrombophilia: results of primary surveillance in Japan. Int J Hematol 116, 364–371 (2022). https://doi.org/10.1007/s12185-022-03354-4

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  • DOI: https://doi.org/10.1007/s12185-022-03354-4

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