What is Thrombophilia?

Thrombophilias are a common group of disorders that make a person more likely to develop blood clots in the veins of their legs, pelvis or lungs.  Below is a list of some known thrombophilias:

Remember that thrombophilias are tendencies and not certainties.  A woman with a thrombophilia will probably never have a blood clot.  However, her chances of having a blood clot are greater compared to a woman without a thrombophilia.

Simple blood tests can be done to determine whether you have a thrombophilia.  If you would like more information about thrombophilia testing, talk to your doctor or contact us.

What are Deep Vein Thrombosis and Pulmonary Embolism?

Deep vein thrombosis occurs when a blood clot forms in the deep veins of the pelvis or leg.  Symptoms of deep vein thrombosis include pain, swelling, redness or warmth in the affected area.  Deep vein thrombosis can lead to a more serious condition, called pulmonary embolism (see below).

Pulmonary embolism occurs when a fragment from a vein blood clot (called an embolus) breaks off, travels in the blood and gets stuck in the blood vessels of the lung.  Pulmonary embolism can be life-threatening if it blocks the blood supply to the lung.  Symptoms of pulmonary embolism include shortness of breath, chest pain that worsens with a deep breath, fast heart beat, sweating, fainting and coughing with blood in the sputum.

In certain situations, a blood thinner (called low molecular weight heparin) is given to prevent or treat deep vein thrombosis and pulmonary embolism.

What about Thrombophilia and Pregnancy Complications?

Pregnancy increases the risk of developing blood clots in the legs, lungs, pelvis and placenta. As described above, people with thrombophilia are more likely to develop blood clots in the veins of their legs, pelvis or lungs.

Pregnant women with thrombophilia have a greater chance of having certain pregnancy complications possibly linked to blood clots in the placentas. These complications are::

·   Recurrent miscarriages

·   Stillbirth

·   Pre-eclampsia (high blood pressure in pregnancy where protein leaks into the urine)

·   Very small birth weigh baby (called intrauterine growth restriction)

·   Bleeding in the placenta before delivery (called abruptio placenta)

At the present time, the standard of care for pregnant women with thrombophilia is close monitoring for the development of these pregnancy complications.   If these complications occur, they are treated accordingly.  However, no treatment has been proven to prevent these complications in pregnant women with thrombophilia.

Is there Any Research Being Done?

Yes.  There is a Canadian clinical trial called TIPPS (Thrombophilia In Pregnancy Prophylaxis Study).  The goal of TIPPS is to determine whether a blood thinner (called low molecular weight heparin) can prevent pregnancy complications in pregnant women with thrombophilia.  The trial office is located in Ottawa, ON Canada (contact us). There are 16 hospitals across Canada, 3 hospitals in Australia and 1 hospital in the United States that are currently participating in this trial. For more information on TIPPS, click here.

What is Low Molecular Weight Heparin?

Low molecular weight heparin is an anti-coagulant, a medication that thins your blood.  In high-risk situations, such as surgery, it may be used to prevent deep vein thrombosis and pulmonary embolism.  It is also used to treat deep vein thrombosis and pulmonary embolism once they have been diagnosed.  Low molecular weight heparin can only be given in injectable form (by needle).  It is given by injection into the fat just underneath your skin, usually the stomach.  It usually has to be injected once or twice a day.

Low molecular weight heparin is safe to use in pregnancy and while breast-feeding.  It does not cross the placenta so can not enter your baby's blood stream.

Although low molecular weight heparin is usually safe, there are some side-effects that can occur.   Bleeding is the most common side effect.  Uncommon side-effects are osteoporosis (a condition which bones become fragile and more likely to break), fractures and low platelet levels (called thrombocytopenia). These rare side effects are reversible once low molecular weight heparin is stopped.