Before planning a pregnancy, every woman should conduct an examination of her body in order to determine possible risks. The fact is that this is caused by a certain need and her name is thrombophilia. This disease was discovered not so long ago and therefore many doctors are still studying pathology. Nevertheless, it is safe to say that two such concepts as hereditary thrombophilia and pregnancy do not combine very well with each other. A serious threat is not only to the expectant mother, but also her child.
With such a disease during pregnancy, the strength of the body is noticeably weakened, because of which the ability of the immune system to withstand internal dangers is seriously reduced. But how great is the threat from such a disease? What diagnostic methods does modern medicine use? And is it even possible to plan a pregnancy in this case?
What is thrombophilia?
The term "thrombophilia" should be understood as the pathological condition of the body, when there is a high probability of blood clots. Under normal conditions, both blood circulation mechanisms (coagulation and anticoagulation) are in a balanced state.
A disappointing diagnosis can be made by detecting a debilitating factor in one of the systems. As a rule, at an early stage of development, the disease does not manifest itself in any way and can be detected by pure chance. These are injuries during surgery, including the detection of hereditary thrombophilia during pregnancy.
Typically, one of the features of pregnancy is to increase plasma coagulation in order to potentially prevent blood loss during childbirth, as well as the likelihood of placental abruption and loss of the baby. Due to increased blood coagulation, there is already a risk of blood clots.
Risk factors
It is worth noting that the mere fact of the presence of the disease gene in a woman is not yet a 100% guarantee that she will definitely face thrombophilia if she is planning a pregnancy. Here a lot depends on a number of provoking factors:
- Pregnancy 35 years or older.
- The presence of obesity.
- Diseases of the liver, cardiovascular system.
- Active smoking (from 10 or more cigarettes per day).
- Phlebeurysm.
- A large number of pregnancy attempts.
- Long-term course of diseases at a chronic stage.
- Long stay in the same position.
- The use of hormonal contraceptives.
- Frequent headaches.
As a number of reviews show, pregnancy with hereditary thrombophilia worries many women. In addition, under the influence of any of the listed factors, the risk of complications during the period of gestation increases significantly.
For this reason, it is necessary to timely identify the characteristic signs of the disease and begin the course of treatment. In this case, it will be possible not only to avoid the consequences, but also to save the child.
Danger of disease
What is fraught with the presence of thrombophilia in the body of a pregnant woman? In most cases, genetic thrombophilia first makes itself felt during pregnancy. This is largely due to the appearance of a third placental circle of blood circulation. As a result, the entire circulatory system is subjected to severe stress.
What is characteristic, there are no capillaries in the placenta at all - the maternal plasma immediately enters this organ, where it flows between the chorionic villi and only then enters the umbilical cord.
As a rule, an ailment does not pose a serious threat to a woman, but only until the moment of conception, when everything changes radically. The risk of developing the consequences of hereditary thrombophilia during pregnancy increases by 5 or 6 times. And the main danger of the disease lies in the likelihood of a miscarriage. And he in the presence of thrombophilia can happen in both the first and last trimester. If a woman was able to bear her baby, then childbirth, as a rule, occurs a little earlier than it should. Usually this is the interval between 35 and 37 weeks, but this option of events can still be considered favorable.
Serious consequences for the child
The formation of blood clots in the vessels of the placenta can cause its insufficiency. In turn, because of this, a delay in the development of the child may occur. In addition, the high probability of oxygen starvation in the fetus (hypoxia) cannot be ruled out. In this case, the baby's body will be supplied with an ever smaller amount of nutrients or they will cease to arrive at all. Ultimately, it can end with the disappointing complications of hereditary thrombophilia during pregnancy. The consequences for the child may be of the following nature:
- detachment of the placenta;
- malformations;
- pregnancy fading;
- miscarriage;
- premature birth;
- stillbirth.
As many experts note, complications begin to appear no earlier than the 10th week of pregnancy. There are no data on the negative effect of thrombophilia on bearing a child before this time.
At the same time, the II trimester with such a disease proceeds calmly. But after 30 weeks, the risks are already increasing - just at this period, fetoplacental insufficiency and severe forms of gestosis can begin to develop.
Diagnosis of the disease
Unfortunately, diagnosing thrombophilia is quite difficult, since the symptoms of the disease are similar to the characteristic signs of varicose veins. Usually this is heaviness and pain in the legs, fatigue. At the same time, there is no point in examining all pregnant women, since hereditary thrombophilia during pregnancy can occur only in 0.1-0.5% of expectant mothers.
In this regard, women can learn about their diagnosis from a qualified specialist who conducts pregnancy throughout the term. For this reason, all potential mothers should responsibly approach the choice of a good gynecologist.
What can alert doctors?
What makes a specialist think that there is a risk of thrombophilia? Typically, a number of factors may indicate this:
- Miscarriage of pregnancy. Usually, this should be understood as unsuccessful pregnancies (2 or 3, or even more), which did not end in childbirth. This also includes fading the development of the child, miscarriage, premature birth, the death of the child.
- Complications of a past pregnancy: placental insufficiency and detachment of the placenta, severe forms of gestosis.
- The formation of blood clots while taking hormonal contraceptives.
- The development of thrombophilia in relatives of a woman.
- Attempts to conduct IVF, which ended in failure.
If the doctor identifies at least one of the factors listed, this is an occasion for a more serious examination.
Hereditary Thrombophilia Pregnancy Planning
The presence of a disease such as thrombophilia, in which hemostasis is seriously impaired, is not a final sentence and in no way is a contraindication to pregnancy. The only thing that should be considered for women who have been diagnosed with this is to remember that they are at risk. In this regard, it is necessary to be as attentive as possible to yourself.
In addition, it is necessary to plan this event in advance and, if necessary, start timely treatment. To do this, go through a series of studies. And if the fact of the development of thrombophilia is detected, the doctor will prescribe the necessary drugs:
- anticoagulants;
- low molecular weight (fractionated) heparin;
- folic acid;
- B vitamins;
- antiplatelet inhibitors (they prevent the formation of blood clots);
- polyunsaturated fatty acids (omega-3);
- micronized progesterone.
When the fact of hereditary thrombophilia before pregnancy is confirmed, women should not panic and even more so deny themselves the joy of motherhood. The fact that the disease was detected before pregnancy was already good. Knowing your position, you can correctly prepare for the upcoming bearing of a child. And to avoid many undesirable consequences.
Essential research for women in position
In pregnant women, the diagnosis of thrombophilia is confirmed on the basis of examination data. In this case, they need to donate blood for analysis twice. For the first time, research is being conducted as part of screening. As a rule, the localization of the pathology of the coagulation system can be detected with such an analysis.
The second time a woman has to undergo specific studies for a more accurate diagnosis. Similar tests for thrombophilia during pregnancy can detect specific disorders that are characteristic of this disease:
- increased plasma density;
- an increase in the number of platelets and red blood cells;
- imbalance between the formed elements of the blood;
- erythrocyte sedimentation rate drop.
After identifying these signs, the pregnant woman is sent to a specialist in a narrow profile - a hematologist.
He usually prescribes more specific tests, which include a series of tests:
- Activated partial thromboplastin time (APTT) - allows you to detect the activity of provocateurs acting on plasma coagulation.
- Thrombin time, or TV test, is the interval during which a blood clot forms.
- The prothrombin index is an indicator of coagulation of blood plasma.
- The presence of a specific protein and antiphospholipid bodies - they are able to destroy cell membranes.
In addition, in order to determine the factors of significant risks of genetic thrombophilia during pregnancy, appropriate examinations are carried out to identify disorders at the cellular level.
Drug therapy
The course of therapy will largely depend on the severity, form of the disease, and gestational age. Moreover, it is necessary to start treatment even at the stage of pregnancy planning or at its early stage. At the same time, it should be borne in mind that the genetic form of the disease is different in that it is impossible to achieve full recovery
Nevertheless, taking medications will stabilize the condition of the pregnant patient. In this case, replacement therapy will provide the body with the missing elements for blood coagulation. For this purpose, injections are carried out using the necessary drugs or droppers are given.
Treatment of hereditary thrombophilia during pregnancy is aimed at eliminating the maximum number of blood clots. In this case, the duration of the course can be 2-4 weeks. In some cases, women need to take medication for life.
A few days before delivery, the use of drugs is canceled. If the process proceeds naturally, the woman will be hospitalized. This is done in order to monitor its condition after the planned cessation of medication.
After 3 days after completing the course of drug therapy, the pregnant woman must pass all the necessary tests. With an increase in the main indicators of plasma and urine, doctors make a responsible decision about artificial birth. Of course, all possible risks are taken into account.
Blood transfusion from thrombophilia during pregnancy
This is another method for treating thrombophilia when planning pregnancy. If the pathological condition proceeds in a mild form, the woman is given intravenous lyophilized blood plasma or dry donor raw materials. In severe stages of thrombophilia, fibrinolytic drugs are connected. Injections are carried out in those places where, in fact, there was a blockage of the blood vessel.
Useful Tips
Women who are undergoing treatment for thrombophilia are not recommended for a long time to be in the same position. However, long walks should also not be carried out! In addition, weight lifting should be avoided!
In order to increase the effectiveness of treatment, as well as to avoid the consequences of hereditary thrombophilia, during pregnancy, a number of useful tips from specialists should be observed:
- You can perform self-massage of affected organs.
- Do not refuse to take prescribed medications.
- Take short walks.
- Strictly adhere to the diet prescribed by your doctor.
- Maintain a balance between work and leisure.
- Physical therapy classes will only benefit.
If a woman led an inactive lifestyle before the development of the disease, then now is the time for significant changes. It is worth moving more, and for pregnant women there are whole complexes of health-improving gymnastics.
In conclusion
Finally, it is worthwhile to give instructions to all women who wish to have a baby, but the diagnosis of thrombophilia somewhat overshadows the mood. Obviously you should not despair! Despite the fact that hereditary thrombophilia and pregnancy are two incompatible concepts, many patients have nurtured and safely gave birth to completely healthy children.
Of course, at the same time, it is necessary to strictly observe all the recommendations of the attending physicians. Indeed, three narrowly focused specialists take part in therapy at once:
- gynecologist;
- hematologist;
- geneticist.
This is due to the fact that therapy requires an integrated approach. In addition, any pregnant woman should be responsible not only for her own well-being, but also for the life of her unborn child. To do this, it is just necessary to show the above-mentioned specialists.