Original Article
Prothrombin and Factor V Mutations in Women with a History of Thrombosis during Pregnancy and the Puerperium
N Engl J Med 2000; 342:374-380February 10, 2000
- Abstract
Background
Venous thromboembolism is a leading cause of morbidity and mortality during pregnancy and the puerperium. However, the role of mutations in the prothrombin and factor V genes and other thrombophilic abnormalities as risk factors for thromboembolism in women during pregnancy and the puerperium is not known.
Methods
In a study of 119 women with a history of venous thromboembolism during pregnancy and the puerperium and 233 age-matched normal women, we measured the activity of antithrombin, protein C, protein S, and lupus anticoagulant. We also performed genetic analyses to detect the G1691A mutation in the factor V gene (factor V Leiden), the G20210A mutation in the prothrombin gene, and the C677T mutation in the methylenetetrahydrofolate reductase gene. Blood samples were obtained at least three months post partum or after the cessation of lactation.
Results
Among the women with a history of venous thromboembolism, the prevalence of factor V Leiden was 43.7 percent, as compared with 7.7 percent among the normal women (relative risk of venous thromboembolism, 9.3; 95 percent confidence interval, 5.1 to 16.9); that of the G20210A prothrombin-gene mutation, 16.9 percent as compared with 1.3 percent (relative risk, 15.2; 95 percent confidence interval, 4.2 to 52.6); and that of both factor V Leiden and the G20210A prothrombin-gene mutation, 9.3 percent as compared with 0 (estimated odds ratio, 107). Assuming an overall risk of 1 in 1500 pregnancies, the risk of thrombosis among carriers of factor V Leiden was 0.2 percent, among carriers of the G20210A prothrombin-gene mutation, 0.5 percent, and among carriers of both defects, 4.6 percent, as calculated in a multivariate analysis.
Conclusions
The G20210A prothrombin-gene mutation and factor V Leiden individually are associated with an increased risk of venous thromboembolism during pregnancy and the puerperium, and the risk among women with both mutations is disproportionately higher than that among women with only one mutation.
Media in This Article
Table 1
Characteristics of the Women with a History of Venous Thromboembolism during Pregnancy and the Puerperium and the Normal Women.Table 2
Prevalence of Hereditary Coagulation Defects.Article Activity
- Article
The risk of venous thromboembolism is five times as high among pregnant women as among nonpregnant women of similar age.1-3 Estimates of the incidence of pregnancy-associated venous thromboembolism vary from 1 in 1000 to 1 in 2000 deliveries.4 Thromboembolic complications, including pulmonary embolism, are major causes of death among women during pregnancy and the puerperium.5 Thus, venous thromboembolism is an uncommon but leading cause of morbidity and mortality among women during this period.
During normal pregnancy, the plasma concentrations and activities of several proteins involved in blood coagulation and fibrinolysis change. These changes may promote coagulation, decrease anticoagulation, and inhibit fibrinolysis5-7 and thus may increase the risk of thromboembolic events, especially among pregnant women who have acquired or genetic risk factors for thrombosis.5,8-10
Among the genetically determined changes, the mutation in the gene encoding factor V at nucleotide 1691 (G1691A, referred to as factor V Leiden) is the most common inherited abnormality in patients with thromboembolic disease, occurring in 20 percent of patients with a first episode of venous thrombosis and up to 50 percent of those with recurrent venous thrombosis.9 A guanine-to-adenine mutation in the prothrombin gene, G20210A, associated with elevated plasma prothrombin concentrations and an increased risk of venous thrombosis, has been identified.11 In addition, homozygosity for a common cytosine-to-thymidine mutation in the gene encoding 5,10-methylenetetrahydrofolate reductase (MTHFR), C677T, is associated with high plasma homocysteine concentrations and venous thrombosis,12-14 although this association has been questioned by some investigators.15
To date, there are limited data on the role of these genetic abnormalities in causing the venous thromboembolism associated with pregnancy and the puerperium.5,8,10,16 We studied the relative risk of venous thromboembolism associated with these genetic markers and other thrombophilic abnormalities in pregnant and puerperal women.
Methods
Subjects
We studied 119 consecutive women with a history of venous thromboembolism during pregnancy and the puerperium (up to six weeks post partum) and 233 normal women. The women with a history of thromboembolism were referred from local hospitals to the Düsseldorf University Medical Center (Düsseldorf, Germany) for treatment of venous thromboembolism between January 1990 and December 1998 and were seen again during 1999 for determination of the presence or absence of genetic risk factors and other thrombophilic abnormalities. In both the women with a history of thromboembolism and the normal women, blood samples were obtained at least three months post partum or three months after the cessation of lactation to rule out any pregnancy-related alterations of coagulation and fibrinolysis. Eight of the 119 women with a history of thromboembolism were receiving long-term oral anticoagulant therapy at the time of blood sampling; 30 of the women with a history of thromboembolism and 92 of the normal women were taking an oral contraceptive at this time.
None of the women had overt evidence of autoimmune or neoplastic disease. Thirteen women with a history of thromboembolism had one or more pregnancy-associated complications: gestational hypertension (3 women), immobilization due to preterm labor (13 women), and twin gestation (2 women). The other 106 women with a history of thromboembolism had normal singleton pregnancies except for the occurrence of the thrombotic event. In four women, none of whom had pregnancy-associated complications, the pregnancy resulted from in vitro fertilization and embryo transfer. Of the 119 women with a history of thromboembolism, 81 had vaginal deliveries (68 percent) and 38 delivered by cesarean section (32 percent).
All the women with a history of thromboembolism had an objectively diagnosed episode of deep venous thrombosis or pulmonary embolism. Deep venous thrombosis was diagnosed by Doppler ultrasonography or computed tomography during pregnancy and by venography or Doppler ultrasonography after delivery. In 77 of these women (65 percent), thrombectomy was performed with complete removal of the thrombus for the prevention of pulmonary embolism, thrombus extension, and the postphlebitic syndrome. In particular, thrombectomy was performed if the thrombus extended into the iliac veins and the inferior caval vein or if a floating thrombus was documented. The procedure was completed with the creation of a temporary arteriovenous fistula, which was removed three to six months later. The details and results of this procedure have been reported elsewhere.17-20 Among these 77 women, thrombectomy was performed in 39 (51 percent) during pregnancy and after delivery in 38 (49 percent).
The 233 normal women were recruited by the Heinrich Heine University Blood Donation Center and matched with the women with a history of thromboembolism according to age. They were from the same geographic region as the women with a history of thromboembolism, but were unrelated to them. One hundred fifty-seven had previous pregnancies with no thromboembolic complications; 148 of these had a vaginal delivery (94 percent) and 9 delivered by cesarean section (6 percent).
Personal histories to document the presence or absence of thromboembolic disease were obtained from all the women with the use of a standardized questionnaire. This procedure has been evaluated previously.21 The study was performed in accordance with the Helsinki Declaration, and written informed consent was given by all the women.
Laboratory Tests
All the women were screened for inherited and acquired defects in blood coagulation. We determined the activities of antithrombin, protein C, protein S, and lupus anticoagulant in plasma and performed a genetic analysis to determine the presence or absence of factor V Leiden, the G20210A prothrombin-gene mutation, and the C677T MTHFR mutation. The activities of plasma protein C and protein S were measured by a functional clotting assay (Instrumentation Laboratory, Milan, Italy), and total protein S antigen and free protein S antigen were measured by immunoelectrophoresis (Boehringer Mannheim, Mannheim, Germany). Plasma antithrombin activity was measured with the use of Berichrom (Dade Behring, Liederbach, Germany). Resistance to activated protein C was determined with a kit (Coatest APC Resistance, Chromogenix, Mölndal, Sweden). Lupus anticoagulant was measured with the DVV test and DVV confirm test (American Diagnostica, Greenwich, Conn.).
The criteria for the diagnosis of deficiencies of protein C, protein S, and antithrombin were activity levels below the lower limit of normal (cutoff, 95th percentile), as determined in blood samples obtained from the 233 normal women. The lower limits of normal were 70 percent for protein C activity, 75 percent for protein C activity after the exclusion of carriers of factor V Leiden, 55 percent for protein S activity, 65 percent for protein S activity after the exclusion of normal women taking an oral contraceptive and carriers of factor V Leiden, and 80 percent for antithrombin activity (with and without oral-contraceptive therapy).
Genetic Analysis
DNA was extracted from peripheral-blood leukocytes according to standard protocols with the use of the Chelex system (Bio-Rad, Munich, Germany). The presence or absence of factor V Leiden was determined by allele-specific restriction-enzyme analysis.22 For confirmation of the genotypes, an oligonucleotide-ligation assay was performed.23 The results of the oligonucleotide-ligation assay were in 100 percent concordance with the results of genotypic analysis, as determined by an allele-specific restriction-enzyme assay. The G20210A prothrombin-gene mutation was identified by allele-specific restriction-enzyme analysis.11 Screening for the presence of the C677T MTHFR polymorphism was performed by the method described by Frosst et al.12
Statistical Analysis
The SAS statistical package (version 6.12, SAS Institute, Cary, N.C.) was used for all statistical analyses. Depending on the type of data, the Wilcoxon rank-sum test, chi-square analysis, or Fisher's exact test (two-tailed) was used to assess the differences between the groups. Multivariate analyses, including the calculation of predictive values, were performed with the use of a stepwise logistic-regression procedure. For the calculation of predictive values, an incidence of 1 thromboembolic event in 1500 pregnancies was assumed. The relative risk was estimated from the odds ratio. Complete data were not available for all the women (e.g., the activities of protein C and protein S were not measured in women with thromboembolism who were taking an oral anticoagulant).
Results
The characteristics of all the women are presented in Table 1Table 1
Characteristics of the Women with a History of Venous Thromboembolism during Pregnancy and the Puerperium and the Normal Women.. Among the 119 women with a history of thromboembolism, 62 (52 percent) had deep venous thromboembolism during pregnancy (first trimester, 14; second trimester, 13; third trimester, 35) and 57 (48 percent) had thromboembolism in the postpartum period (vaginal delivery, 38; cesarean section, 19). In the 35 women with a history of thromboembolism during the third trimester, 11 (31 percent) had a cesarean section followed immediately by thrombectomy. In 96 women, the venous thrombosis occurring during pregnancy or the puerperium was their first thrombotic event, whereas in 23 women the venous thrombosis was a recurrent thrombotic event. The prevalence of genetic risk factors did not differ significantly between the women with a history of thromboembolism who underwent thrombectomy and those who did not or between the women with a history of thromboembolism who had no pregnancy-associated complications and those with thromboembolism who had pregnancy-associated complications. We therefore do not present separate analyses of the results.Prevalence of Inherited Risk Factors
The prevalence of factor V Leiden was significantly higher among the women with a history of thromboembolism than among the normal women (Table 2Table 2
Prevalence of Hereditary Coagulation Defects. and Table 3Table 3
Relative Risk of Venous Thromboembolism Associated with Hereditary Coagulation Defects.). Similarly, the prevalence of the G20210A prothrombin-gene mutation was significantly higher among the women with a history of thromboembolism than among the normal women (Table 2 and Table 3). Of the women with a history of venous thromboembolism who had factor V Leiden, 5 were homozygous and 47 were heterozygous for the mutation; all of the women with the G20210A prothrombin-gene mutation were heterozygous for the mutation.Eleven of 118 women with a history of thromboembolism (9.3 percent) had both factor V Leiden and the G20210A prothrombin-gene mutation (estimated odds ratio for thromboembolism during pregnancy and the puerperium, 107). Since no normal women had this combined defect, the estimated odds ratio was calculated on the basis of the probability of a combined defect in the normal women (7.7 percent × 1.3 percent=0.10 percent).
The prevalence of the other risk factors for thrombophilia (deficiencies of antithrombin, protein C, and protein S) was 24.8 percent in the women with a history of thromboembolism and 11.4 percent in the normal women. A total of 19.3 percent of the women with a history of thromboembolism (23 of 119) had an antithrombin deficiency (<80 percent of normal activity), as compared with 2.6 percent of the normal women (6 of 231) (relative risk, 9.0; 95 percent confidence interval, 3.5 to 22.7; P<0.001); a difference, although not significant, persisted after the exclusion of the women taking an oral contraceptive (Table 2). A total of 12.4 percent of the women with a history of thromboembolism (13 of 105) and 4.8 percent of the normal women (11 of 228) had reduced protein S activity (<55 percent of normal activity; relative risk, 2.8; 95 percent confidence interval, 1.2 to 6.5; P= 0.01); this difference did not persist after the exclusion of the women taking an oral contraceptive and the carriers of factor V Leiden (Table 2). A total of 14.2 percent of the women with a history of thromboembolism (15 of 106) had protein C deficiency, as compared with 3.9 percent of the normal women (9 of 230) (relative risk, 4.0; 95 percent confidence interval, 1.7 to 9.6; P<0.001). The difference persisted after the exclusion of the carriers of factor V Leiden (Table 2). Among the women with a history of thromboembolism who had deficiencies of antithrombin, protein C, and protein S, most had activity levels that ranged between 50 percent and 65 percent of normal activity. One woman with a history of thromboembolism had an antithrombin activity of <50 percent, and two had a protein C activity of <50 percent, whereas none of the normal women had levels this low.
In a logistic-regression analysis in which adjustments were made for age, body-mass index, and oral-contraceptive use or nonuse (Table 3) and in which protein C deficiency, protein S deficiency, antithrombin deficiency, and presence of factor V Leiden, the G20210A prothrombin-gene mutation, and the 677TT MTHFR genotype were included in the same model, only antithrombin deficiency (<80 percent of normal activity) and the presence of factor V Leiden and the G20210A prothrombin-gene mutation could be identified as independent risk factors that were predictive of thrombosis in the women with thromboembolism.
Predictors of Thrombosis in Pregnancy as Compared with Those in the Puerperium
There was no significant difference in the prevalence of factor V Leiden, the G20210A prothrombin-gene mutation, protein C deficiency, and protein S deficiency between the 62 women with a history of thromboembolism during pregnancy and the 57 women with a history of thromboembolism during the puerperium. There was a trend toward a higher prevalence of antithrombin deficiency among the women with a history of venous thromboembolism in pregnancy than among the women with a history of thromboembolism during the puerperium (prevalence, 11.1 percent vs. 2.3 percent; P=0.10). By contrast, the MTHFR 677TT genotype was predominantly associated with thrombosis in the puerperium (prevalence, 30.0 percent among the women with thromboembolism during the puerperium vs. 8.8 percent among the women with thromboembolism during pregnancy; P=0.04).
There was no statistical difference with regard to the prevalence or relative risk of inherited risk factors between the women with a history of thromboembolism who had vaginal deliveries and those who had cesarean deliveries.
Recurrent Venous Thromboembolism
The prevalence and relative risk of genetic risk factors among the women with a first episode of thromboembolism and among those with recurrent thromboembolism, as compared with normal women, are shown in Table 4Table 4
Prevalence and Relative Risk of Hereditary Coagulation Defects in Women with First or Recurrent Venous Thromboembolism as Compared with Normal Women.. We also compared the prevalence and relative risk of these risk factors among 79 women with a first episode of thromboembolism with those among the 40 women who had recurrent thromboembolism. The presence of the G20210A prothrombin-gene mutation, the presence of antithrombin deficiency, and the presence of protein C deficiency were associated with recurrent venous thrombotic events. Women with recurrent thromboembolism had significantly more combined defects than did women with a first episode (prevalence of factor V Leiden plus protein C deficiency, 14.7 percent vs. 1.4 percent, P=0.006; prevalence of factor V Leiden plus antithrombin deficiency, 20 percent vs. 7.7 percent, P= 0.05; prevalence of the G20210A prothrombin-gene mutation plus antithrombin deficiency, 12.8 percent vs. 0 percent, P=0.004).Positive Predictive Value of Hereditary Risk Factors
For the carriers of hereditary risk factors, the positive predictive values indicating the probability of thrombosis per pregnancy and puerperium were calculated in a multivariate analysis. An incidence of 1 thromboembolic event in 1500 pregnancies was assumed. The probability of thrombosis among women without any risk factor was 0.03 percent (95 percent confidence interval, 0.02 to 0.04 percent); among those with factor V Leiden, 0.25 percent (95 percent confidence interval, 0.2 to 0.3 percent); among those with the G20210A prothrombin-gene mutation, 0.5 percent (95 percent confidence interval, 0.3 to 0.8 percent); among those with antithrombin deficiency (<80 percent of normal activity), 0.4 percent (95 percent confidence interval, 0.3 to 0.6 percent); and among those with protein C deficiency (<75 percent of normal activity), 0.1 percent (95 percent confidence interval, 0.04 to 0.13 percent). The combination of factor V Leiden plus the G20210A prothrombin-gene mutation was associated with a probability of thrombosis of 4.6 percent (95 percent confidence interval, 2.6 to 8.2 percent).
Discussion
Thromboembolic complications, including pulmonary embolism, that occur during pregnancy and the puerperium are a major cause of maternal morbidity and mortality. Our results indicate that the relative risk of venous thromboembolism among women with the G20210A prothrombin-gene mutation is at least as high as that among those with factor V Leiden. Previous studies demonstrated a relative risk of venous thromboembolism of between 3.0 and 5.0 associated with the G20210A prothrombin-gene mutation11,24-26; in contrast, we found a much higher relative risk of venous thromboembolism during pregnancy and the puerperium among women with this defect. There appears to be a relation between the presence of the G20210A prothrombin-gene mutation and pregnancy-related alterations in coagulation or fibrinolysis that lead to thrombosis in women who are carriers of the G20210A prothrombin-gene mutation. A similar observation was recently reported for cerebral-vein thrombosis in women taking an oral contraceptive.27
We confirmed the importance of factor V Leiden as a risk factor for venous thromboembolism during pregnancy and the puerperium.10,16 In addition, we found that factor V Leiden is a risk factor that is independent of other known determinants of the risk of thrombosis; specifically, it is independent of the G20210A prothrombin-gene mutation. It is remarkable that as many as 9.3 percent of the women had both the G20210A prothrombin-gene mutation and factor V Leiden, leading to a disproportionately higher risk than with either defect alone.
There are conflicting results regarding the role of a homozygous 677TT MTHFR genotype as a risk factor for venous thromboembolism. Homozygosity for this polymorphism was associated with high plasma homocysteine concentrations and venous thrombosis in some studies12-14 but not in others.15 In our study, the 677TT MTHFR genotype had no influence on the risk of venous thromboembolism, although the prevalence of the 677TT MTHFR genotype in the subgroup of women with venous thromboembolism during the puerperium was higher than in the subgroup of women with venous thromboembolism during pregnancy.
In the analysis of the risk associated with deficiencies of antithrombin, protein C, and protein S, only antithrombin deficiency was an independent risk factor for thromboembolism after adjustments were made for the presence of factor V Leiden and oral-contraceptive use. However, the number of women with deficiencies of protein C and protein S may be too low for it to be possible to identify an influence of each of these risk factors independently in a multivariate analysis. It is well known that resistance to activated protein C is associated with decreased protein S activity, as determined by routine assays. We found that resistance to activated protein C was also associated with decreased protein C activity in a group of 500 normal men and women (data not shown). In addition to antithrombin deficiency and the G20210A prothrombin-gene mutation, the presence of protein C deficiency was associated with recurrent venous thromboembolism during pregnancy and the puerperium, particularly when it was present with other defects.
The predictive value of factor V Leiden and other inherited markers for the purpose of screening for thrombotic risk is low among pregnant women. A significant increase in the probability of thrombosis can be demonstrated only in cases in which a woman has a combined defect (as evidenced by a probability of 4.6 percent for women with both factor V Leiden and the G20210A prothrombin-gene mutation).
Supported by an institutional interdisciplinary program in vascular medicine sponsored by Hoffmann–La Roche.
Source Information
From the Departments of Hemostasis and Transfusion Medicine (A.G., R.E.S., R.B.Z.), Obstetrics and Gynecology (M.W.B., S.S., H.G.B.), and Vascular Surgery and Kidney Transplantation (M.P., W.S.), Heinrich Heine University Medical Center, Düsseldorf, Germany.
Address reprint requests to Dr. Zotz at the Institut für Haemostaseologie und Transfusionsmedizin, Heinrich Heine Universität, Moorenstr. 5, D-40225 Düsseldorf, Germany, or at zotz@med.uni-duesseldorf.de.
- References
References
1
Prevention of venous thrombosis and pulmonary embolism: NIH Consensus Development
CrossRef | Web of Science2
Kierkegaard A . Incidence and diagnosis of deep vein thrombosis associated with pregnancy. Acta Obstet Gynecol Scand 1983;62:239-243
CrossRef | Web of Science | Medline3
Treffers PE ,Huidekoper BL ,Weenink GH ,Kloosterman GJ . Epidemiological observations of thrombo-embolic disease during pregnancy and in the puerperium, in 56,022 women. Int J Gynaecol Obstet 1983;21:327-331
CrossRef | Web of Science | Medline4
Rutherford S ,Montoro M ,McGehee W ,Strong T . Thromboembolic disease associated with pregnancy: an 11-year review. Am J Obstet Gynecol 1991;164:Suppl:286-286 abstract.5
Hellgren M ,Svensson PJ ,Dahlback B . Resistance to activated protein C as a basis for venous thromboembolism associated with pregnancy and oral contraceptives. Am J Obstet Gynecol 1995;173:210-213
CrossRef | Web of Science | Medline6
Greer IA. Haemostasis and thrombosis in pregnancy. In: Bloom AL, Forbes CD, Thomas DP, Tuddenham EGD, eds. Haemostasis and thrombosis. Vol. 2. Edinburgh, Scotland: Churchill Livingstone, 1994:987-1015.
7
Dahlbäck B, Stenflo J. A natural anticoagulant pathway: protein C, S, C4b-binding protein and thrombomodulin. In: Bloom AL, Forbes CD, Thomas DP, Tuddenham EGD, eds. Haemostasis and thrombosis. Vol. 1. Edinburgh, Scotland: Churchill Livingstone, 1994:671-98.
8
Dizon-Townson DS ,Nelson LM ,Jang H ,Varner MW ,Ward K . The incidence of the factor V Leiden mutation in an obstetric population and its relationship to deep vein thrombosis. Am J Obstet Gynecol 1997;176:883-886
CrossRef | Web of Science | Medline9
Bertina RM ,Koeleman BP ,Koster T , et al. Mutation in blood coagulation factor V associated with resistance to activated protein C. Nature 1994;369:64-67
CrossRef | Web of Science | Medline10
Bokarewa MI ,Bremme K ,Blomback M . Arg506-Gln mutation in factor V and risk of thrombosis during pregnancy. Br J Haematol 1996;92:473-478
CrossRef | Web of Science | Medline11
Poort SR ,Rosendaal FR ,Reitsma PH ,Bertina RM . A common genetic variation in the 3'-untranslated region of the prothrombin gene is associated with elevated plasma prothrombin levels and an increase in venous thrombosis. Blood 1996;88:3698-3703
Web of Science | Medline12
Frosst P ,Blom HJ ,Milos R , et al. A candidate genetic risk factor for vascular disease: a common mutation in methylenetetrahydrofolate reductase. Nat Genet 1995;10:111-113
CrossRef | Web of Science | Medline13
Margaglione M ,D'Andrea G ,d'Addedda M , et al. The methylenetetrahydrofolate reductase TT677 genotype is associated with venous thrombosis independently of the coexistence of the FV Leiden and the prothrombin A20210 mutation. Thromb Haemost 1998;79:907-911
Web of Science | Medline14
Eichinger S ,Stumpflen A ,Hirschl M , et al. Hyperhomocysteinemia is a risk factor of recurrent venous thromboembolism. Thromb Haemost 1998;80:566-569
Web of Science | Medline15
Kluijtmans LAJ ,den Heijer M ,Reitsma PH ,Heil SG ,Blom HJ ,Rosendaal FR . Thermolabile methylenetetrahydrofolate reductase and factor V Leiden in the risk of deep-vein thrombosis. Thromb Haemost 1998;79:254-258
Web of Science | Medline16
Hallak M ,Senderowicz J ,Cassel A , et al. Activated protein C resistance (factor V Leiden) associated with thrombosis in pregnancy. Am J Obstet Gynecol 1997;176:889-893
CrossRef | Web of Science | Medline17
Kniemeyer HW ,Merckle R ,Stuhmeier K ,Sandmann W . Chirurgische Therapie der akuten und embolisierenden tiefen Beinvenenthrombose -- Indikation, Technisches Prinzip, Ergebnisse. Klin Wochenschr 1990;68:1208-1216
CrossRef | Medline18
Kniemeyer HW ,Sandmann W . Chirurgische Therapie der tiefen Venenthrombose in Schwangerschaft und Wochenbett. Gynakologe 1990;23:91-96
Web of Science | Medline19
Kolvenbach R ,Grabitz K ,Distler W ,Eichwede F ,Sandmann W . Die embolisierende Bein- und Beckenvenenthrombose in der Spät-Schwangerschaft: Indikation für ein simultanes, interdisziplinäres Vorgehen. Gynakologe 1991;24:305-306
Web of Science | Medline20
Kniemeyer HW ,Sandmann W ,Schwindt C ,Grabitz K ,Torsello G ,Stuhmeier K . Thrombectomy with arteriovenous fistula for embolizing deep venous thrombosis: an alternative therapy for prevention of recurrent pulmonary embolism. Clin Investig 1993;72:40-45
CrossRef | Medline21
Frezzato M ,Tosetto A ,Rodeghiero F . Validated questionnaire for the identification of previous personal or familial venous thromboembolism. Am J Epidemiol 1996;143:1257-1265
Web of Science | Medline22
Ridker PM ,Hennekens CH ,Lindpaintner K ,Stampfer MJ ,Eisenberg PR ,Miletich JP . Mutation in the gene coding for coagulation factor V and the risk of myocardial infarction, stroke, and venous thrombosis in apparently healthy men. N Engl J Med 1995;332:912-917
Full Text | Web of Science | Medline23
Zotz RB ,Maruhn-Debowski B ,Scharf RE . Mutation in the gene coding for coagulation factor V and resistance to activated protein C: detection of the genetic mutation by oligonucleotide ligation assay using a semi-automated system. Thromb Haemost 1996;76:53-55
Web of Science | Medline24
Cumming AM ,Keeney S ,Salden A ,Bhavnani M ,Shwe KH ,Hay CRM . The prothrombin gene G20210A variant: prevalence in a U.K. anticoagulant clinic population. Br J Haematol 1997;98:353-355
CrossRef | Web of Science | Medline25
Hillarp A ,Zoller B ,Svensson PJ ,Dahlback B . The 20210 A allele of the prothrombin gene is a common risk factor among Swedish outpatients with verified deep venous thrombosis. Thromb Haemost 1997;78:990-992
Web of Science | Medline26
Leroyer C ,Mercier B ,Oger E , et al. Prevalence of 20210 A allele of the prothrombin gene in venous thromboembolism patients. Thromb Haemost 1998;80:49-51
Web of Science | Medline27
Martinelli I ,Sacchi E ,Landi G ,Taioli E ,Duca F ,Mannucci PM . High risk of cerebral-vein thrombosis in carriers of a prothrombin-gene mutation and in users of oral contraceptives. N Engl J Med 1998;338:1793-1797
Full Text | Web of Science | Medline
- Citing Articles (146)
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1
Lee T. Dresang, Lawrence Leeman. (2012) Cesarean Delivery. Primary Care: Clinics in Office Practice 39:1, 145-165
CrossRef2
Michael J. Paidas. 2012. Inherited and Acquired Thrombophilias. , 108-120.
CrossRef3
James A. Airoldi. 2011. Inherited thrombophilia. , 207-214.
CrossRef4
Kelly McNamee, Feroza Dawood, Roy G. Farquharson. (2011) Thrombophilia and early pregnancy loss. Best Practice & Research Clinical Obstetrics & Gynaecology
CrossRef5
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CrossRef6
Evgeny V Sidorov, Wuwei Feng, Louis R Caplan. (2011) Stroke in pregnant and postpartum women. Expert Review of Cardiovascular Therapy 9:9, 1235-1247
CrossRef7
2011. , 377-396.
CrossRef8
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CrossRef9
E.M. Battinelli, K.A. Bauer. (2011) Thrombophilias in Pregnancy. Hematology/Oncology Clinics of North America 25:2, 323-333
CrossRef10
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CrossRef11
Jody Lynn Kujovich. (2011) Factor V Leiden thrombophilia. Genetics in Medicine 13:1, 1-16
CrossRef12
M. Rodger. (2010) Evidence Base for the Management of Venous Thromboembolism in Pregnancy. Hematology 2010:1, 173-180
CrossRef13
Julia A.M. Anderson, Jeffrey I. Weitz. (2010) Hypercoagulable States. Clinics in Chest Medicine 31:4, 659-673
CrossRef14
Michael J. Paidas, Christina S. Han, Nazli Hossain, Charles J. Lockwood. 2010. Inherited and Acquired Thrombophilia in Obstetrics. , 67-110.
CrossRef15
Marc A. Rodger, Genevieve Le Templier. 2010. Anticoagulant Therapy During Pregnancy and Gynecology. , 111-152.
CrossRef16
A. F. JACOBSEN, A. DAHM, A. BERGREM, E. M. JACOBSEN, P. M. SANDSET. (2010) Risk of venous thrombosis in pregnancy among carriers of the factor V Leiden and the prothrombin gene G20210A polymorphisms. Journal of Thrombosis and Haemostasis 8:11, 2443-2449
CrossRef17
Donna Dizon-Townson. 2010. Thromboembolic Disease. , 283-307.
CrossRef18
Chiara Benedetto, Luca Marozio, Anna Maria Tavella, Loredana Salton, Sara Grivon, Francesca Di Giampaolo. (2010) Coagulation disorders in pregnancy: acquired and inherited thrombophilias. Annals of the New York Academy of Sciences 1205:1, 106-117
CrossRef19
Catherine Nelson-Piercy, Ian Greer. 2010. Thromboembolic Disease in Pregnancy. , 82-100.
CrossRef20
Marc A. Rodger, Michael Paidas, Lawrence Tsen, Joanne Douglas. 2010. Thrombophilias and Pregnancy. , 101-117.
CrossRef21
Charles Lockwood, Erika Werner. 2010. Acquired and Inherited Thrombophilias. , 185-194.
CrossRef22
Carolyn R. Jaslow, Judi L. Carney, William H. Kutteh. (2010) Diagnostic factors identified in 1020 women with two versus three or more recurrent pregnancy losses. Fertility and Sterility 93:4, 1234-1243
CrossRef23
Amanda L. Horton, Valerija Momirova, Donna Dizon-Townson, Katharine Wenstrom, George Wendel, Philip Samuels, Baha Sibai, Catherine Y. Spong, Margaret Cotroneo, Yoram Sorokin, Menachem Miodovnik, Mary J. OʼSullivan, Deborah Conway, Ronald J. Wapner. (2010) Family History of Venous Thromboembolism and Identifying Factor V Leiden Carriers During Pregnancy. Obstetrics & Gynecology 115:3, 521-525
CrossRef24
Peggy Walker, Anthony R. Gregg. (2010) Screening, Testing, or Personalized Medicine: Where do Inherited Thrombophilias Fit Best?. Obstetrics and Gynecology Clinics of North America 37:1, 87-107
CrossRef25
Andra H. James. (2010) Pregnancy and thrombotic risk. Critical Care Medicine 38, S57-S63
CrossRef26
Sung-Chun Tang, Jiann-Shing Jeng. (2010) Management of stroke in pregnancy and the puerperium. Expert Review of Neurotherapeutics 10:2, 205-215
CrossRef27
Robert M. Silver, Yuan Zhao, Catherine Y. Spong, Baha Sibai, George Wendel, Katharine Wenstrom, Philip Samuels, Steve N. Caritis, Yoram Sorokin, Menachem Miodovnik, Mary J. OʼSullivan, Deborah Conway, Ronald J. Wapner. (2010) Prothrombin Gene G20210A Mutation and Obstetric Complications. Obstetrics & Gynecology 115:1, 14-20
CrossRef28
Susan Murin, Kathryn Bilello, Lisa Moores, Aaron Holley. 2010. Gender Issues in Venous Thromboembolism. , 225-243.
CrossRef29
Federico Lussana, Francesco Dentali, Rosanna Abbate, Ernesto d'Aloja, Armando D'Angelo, Valerio De Stefano, Elena M. Faioni, Elvira Grandone, Cristina Legnani, Ida Martinelli, Paolo Simioni, Daniela Tormene. (2009) Screening for thrombophilia and antithrombotic prophylaxis in pregnancy: Guidelines of the Italian Society for Haemostasis and Thrombosis (SISET). Thrombosis Research 124:5, e19-e25
CrossRef30
Jeffrey I. Weitz. (2009) Prevention and treatment of venous thromboembolism during pregnancy. Catheterization and Cardiovascular Interventions 74:S1, S22-S26
CrossRef31
Yesim Dargaud, Lucia Rugeri, Marie Christine Vergnes, Brigitte Arnuti, Paula Miranda, Claude Negrier, Audrey Bestion, Hélène Desmurs-Clavel, Jacques Ninet, Pascal Gaucherand, Rene Charles Rudigoz, Michel Berland, Fabienne Champion, Marie Christine Trzeciak. (2009) A risk score for the management of pregnant women with increased risk of venous thromboembolism: a multicentre prospective study. British Journal of Haematology 145:6, 825-835
CrossRef32
Marcelo P. Villa-Forte Gomes. (2009) Venous thromboembolism in pregnancy. Current Treatment Options in Cardiovascular Medicine 11:2, 104-113
CrossRef33
Valeria Matus, Johan Willemse, Teresa Quiroga, Manuela Goycoolea, Eduardo Aranda, Olga Panes, Jaime Pereira, Dirk Hendriks, Diego Mezzano. (2009) Procarboxypeptidase U (TAFI) and the Thr325Ile proCPU polymorphism in patients with hereditary mucocutaneous hemorrhages. Clinica Chimica Acta 401:1-2, 158-161
CrossRef34
Paolo Simioni. (2009) Thrombophilia and gestational VTE. Thrombosis Research 123, S41-S44
CrossRef35
Gorana Mitic, Ljubica Povazan, Radmila Lazic, Dragan Spasic, Milana Maticki-Sekulic. (2009) Deficiency of the natural anticoagulant proteins in women with pregnancy related venous thromboembolism. Medicinski pregled 62:1-2, 53-62
CrossRef36
Andra H James. (2008) Thromboembolism in pregnancy: recurrence risks, prevention and management. Current Opinion in Obstetrics and Gynecology 20:6, 550-556
CrossRef37
Joanne M. SAID, Shaun P. BRENNECKE, Eric K. MOSES, Susan P. WALKER, Paul T. MONAGLE, Janine CAMPBELL, Valerie J. BRYANT, Anthony J. BORG, John R. HIGGINS. (2008) The prevalence of inherited thrombophilic polymorphisms in an asymptomatic Australian antenatal population. Australian and New Zealand Journal of Obstetrics and Gynaecology 48:6, 536-541
CrossRef38
Michael J Paidas, De-Hui W Ku, Gabriele Urban, Nazli Hossain, Andrei Rebarber, Charles J Lockwood, Yale S Arkel. (2008) Elevated first trimester soluble fibrin polymer is associated with adverse pregnancy outcome in thrombophilic patients. Blood Coagulation & Fibrinolysis 19:8, 824-826
CrossRef39
Fernando Uresandi, Gemma Iruin, Beatriz Gómez, Amaia Uresandi. (2008) Seguimiento de la tromboembolia pulmonar. Medicina Clínica 131, 54-59
CrossRef40
Verena Gartner, Michael Weber, Sabine Eichinger. (2008) The emotional impact of genetic testing and aspects of counseling prior to prescription of oral contraceptives. Contraception 78:5, 392-398
CrossRef41
S. L. MEEKS, T. C. ABSHIRE. (2008) Abnormalities of prothrombin: a review of the pathophysiology, diagnosis, and treatment. Haemophilia 14:6, 1159-1163
CrossRef42
Christina M. Scifres, George A. Macones. (2008) The utility of thrombophilia testing in pregnant women with thrombosis: fact or fiction?. American Journal of Obstetrics and Gynecology 199:4, 344.e1-344.e7
CrossRef43
E. R. POMP, A. M. LENSELINK, F. R. ROSENDAAL, C. J. M. DOGGEN. (2008) Pregnancy, the postpartum period and prothrombotic defects: risk of venous thrombosis in the MEGA study. Journal of Thrombosis and Haemostasis 6:4, 632-637
CrossRef44
I. MARTINELLI, T. BATTAGLIOLI, V. DE STEFANO, D. TORMENE, L. VALDRÈ, E. GRANDONE, A. TOSETTO, P. M. MANNUCCI, . (2008) The risk of first venous thromboembolism during pregnancy and puerperium in double heterozygotes for factor V Leiden and prothrombin G20210A. Journal of Thrombosis and Haemostasis 6:3, 494-498
CrossRef45
Céline Chauleur, Sara Quenet, Marie-Noëlle Varlet, Pierre Seffert, Silvy Laporte, Hervé Decousus, Patrick Mismetti. (2008) Feasibility of an easy-to-use risk score in the prevention of venous thromboembolism and placental vascular complications in pregnant women: A prospective cohort of 2736 women. Thrombosis Research 122:4, 478-484
CrossRef46
Benjamin Brenner, Anat Aharon. (2007) Thrombophilia and Adverse Pregnancy Outcome. Clinics in Perinatology 34:4, 527-541
CrossRef47
Adam J. Duhl, Michael J. Paidas, Serdar H. Ural, Ware Branch, Holly Casele, Joan Cox-Gill, Sheri Lynn Hamersley, Thomas M. Hyers, Vern Katz, Randall Kuhlmann, Edith A. Nutescu, James A. Thorp, James L. Zehnder. (2007) Antithrombotic therapy and pregnancy: consensus report and recommendations for prevention and treatment of venous thromboembolism and adverse pregnancy outcomes. American Journal of Obstetrics and Gynecology 197:5, 457.e1-457.e21
CrossRef48
Jennifer Voke, Jane Keidan, Sue Pavord, Neil H. Spencer, Beverley J. Hunt, . (2007) The management of antenatal venous thromboembolism in the UK and Ireland: a prospective multicentre observational survey. British Journal of Haematology 139:4, 545-558
CrossRef49
Victor A. Rosenberg, Charles J. Lockwood. (2007) Thromboembolism in Pregnancy. Obstetrics and Gynecology Clinics of North America 34:3, 481-500
CrossRef50
Scott M Nelson, Ian A Greer. (2007) Thrombophilia and maternal mortality: risk factors and preventive approaches. Expert Review of Obstetrics & Gynecology 2:4, 477-488
CrossRef51
Mrinal M Patnaik, Tufia Haddad, Colleen T Morton. (2007) Pregnancy and thrombophilia. Expert Review of Cardiovascular Therapy 5:4, 753-765
CrossRef52
Andra H. James, Chad A. Grotegut, Leo R. Brancazio, Haywood Brown. (2007) Thromboembolism in Pregnancy: Recurrence and Its Prevention. Seminars in Perinatology 31:3, 167-175
CrossRef53
Vicente Vicente, Javier Corral. (2007) Trombofilia hereditaria: lecciones aprendidas y deberes pendientes. Medicina Clínica 128:17, 657-659
CrossRef54
É. COCHERY-NOUVELLON, É. MERCIER, G. LISSALDE-LAVIGNE, J.-P. DAURÈS, I. QUÉRé, M. DAUZAT, P. MARÈS, J.-C. GRIS. (2007) Homozygosity for the C46T polymorphism of the F12 gene is a risk factor for venous thrombosis during the first pregnancy. Journal of Thrombosis and Haemostasis 5:4, 700-707
CrossRef55
Rainer B Zotz, Andrea Gerhardt, Rüdiger E Scharf. (2007) Inherited thrombophilia and gestational venous thromboembolism. Women's Health 3:2, 215-225
CrossRef56
Thomas C. Krivak, Kristin K. Zorn. (2007) Venous Thromboembolism in Obstetrics and Gynecology. Obstetrics & Gynecology 109:3, 761-777
CrossRef57
Adi Y Weintraub, Fernanda Press, Arnon Wiznitzer, Eyal Sheiner. (2007) Maternal thrombophilia and adverse pregnancy outcomes. Expert Review of Obstetrics & Gynecology 2:2, 203-216
CrossRef58
Aba Barden-Maja, C. Jessica Dine, Laura M. Kosseim, Jodi Savitz, Daniel I. Steinberg. 2007. Selected Medical Problems Encountered During Pregnancy. , 444-491.
CrossRef59
S. M. Bates. (2007) Management of Pregnant Women with Thrombophilia or a History of Venous Thromboembolism. Hematology 2007:1, 143-150
CrossRef60
Jody L. Kujovich, Barbara M. Alving. 2007. Management of Thrombophilia and Antiphospholipid Syndrome During Pregnancy. , 593-609.
CrossRef61
ROBERT M. SILVER, JENNIFER E. WARREN. (2006) Preconception Counseling for Women With Thrombophilia. Clinical Obstetrics and Gynecology 49:4, 906-919
CrossRef62
Kjersti Aagaard-Tillery, Baha Sibai, Catherine Y. Spong, Valerija Momirova, George Wendel, Katharine Wenstrom, Philip Samuels, Margaret Cotroneo, Atef Moawad, Yoram Sorokin, Menachem Miodovnik, Paul Meis, Mary J. O’Sullivan, Deborah Conway, Ronald J. Wapner. (2006) Sample Bias Among Women With Retained DNA Samples for Future Genetic Studies. Obstetrics & Gynecology 108:5, 1115-1120
CrossRef63
Nagaraja Dindagur, T.P. Kruthika-Vinod, Rita Christopher. (2006) Thrombophilic gene polymorphisms in puerperal cerebral veno-sinus thrombosis. Journal of the Neurological Sciences 249:1, 25-30
CrossRef64
Jean-Christophe Gris, Géraldine Lissalde-Lavigne, Isabelle Quéré, Michel Dauzat, Pierre Marès. (2006) Prophylaxis and treatment of thrombophilia in pregnancy. Current Opinion in Hematology 13:5, 376-381
CrossRef65
B BRENNER. (2006) Thrombophilia and Adverse Pregnancy Outcome. Obstetrics and Gynecology Clinics of North America 33:3, 443-456
CrossRef66
S NELSON. (2006) Thrombophilia and the Risk for Venous Thromboembolism during Pregnancy, Delivery, and Puerperium. Obstetrics and Gynecology Clinics of North America 33:3, 413-427
CrossRef67
Michelle A. Kominiarek, Judith U. Hibbard. (2006) Postpartum Ovarian Vein Thrombosis: An Update. Obstetrical & Gynecological Survey 61:5, 337-342
CrossRef68
Min Min Chou. (2006) Litigation in Obstetrics: a Lesson Learnt and a Lesson to Share. Taiwanese Journal of Obstetrics and Gynecology 45:1, 1-9
CrossRef69
S. Arul Anne Rose, Sumana Manohar. (2006) Thromboprophylaxis in Obstetrics and Gynaecology. Apollo Medicine 3:1, 10-14
CrossRef70
L. Robertson, O. Wu, P. Langhorne, S. Twaddle, P. Clark, G. D. O. Lowe, I. D. Walker, M. Greaves, I. Brenkel, L. Regan, I. A. Greer, . (2006) Thrombophilia in pregnancy: a systematic review. British Journal of Haematology 132:2, 171-196
CrossRef71
Massimo Franchini, Dino Veneri, Gian Luca Salvagno, Franco Manzato, Giuseppe Lippi. (2006) Inherited Thrombophilia. Critical Reviews in Clinical Laboratory Sciences 43:3, 249-290
CrossRef72
José Ramón González-Porras, Ramón García-Sanz, Ignacio Alberca, María Luz López, Ana Balanzategui, Oliver Gutierrez, Francisco Lozano, Jesús San Miguel. (2006) Risk of recurrent venous thrombosis in patients with G20210A mutation in the prothrombin gene or factor V Leiden mutation. Blood Coagulation & Fibrinolysis 17:1, 23-28
CrossRef73
Ambros Huber, Christoph C. Keck, Lukas A. Hefler, Christian Schneeberger, Johannes C. Huber, Eva-Katrin Bentz, Clemens B. Tempfer. (2005) Ten Estrogen-Related Polymorphisms and Endometriosis. Obstetrics & Gynecology 106:5, Part 1, 1025-1031
CrossRef74
M. Pillny, W. Sandmann. (2005) Chirurgische Therapie der Beinvenenthrombose. Gefässchirurgie 10:5, 367-375
CrossRef75
Joanne N. Quiñones, Denise N. James, David M. Stamilio, Kirsten Lawrence Cleary, George A. Macones. (2005) Thromboprophylaxis After Cesarean Delivery. Obstetrics & Gynecology 106:4, 733-740
CrossRef76
, , , , , , , , , , , , , , , , . (2005) Interdisziplinäre S2-Leitlinie. Diagnostik und Therapie der Bein- und Beckenvenenthrombose und der Lungenembolie. Intensivmedizin und Notfallmedizin 42:7, 552-565
CrossRef77
Donna Dizon-Townson, Connie Miller, Baha Sibai, Catherine Y. Spong, Elizabeth Thom, George Wendel, Katharine Wenstrom, Philip Samuels, Margaret A. Cotroneo, Atef Moawad, Yoram Sorokin, Paul Meis, Menachem Miodovnik, Mary J. O’Sullivan, Deborah Conway, Ronald J. Wapner, Steven G. Gabbe. (2005) The Relationship of the Factor V Leiden Mutation and Pregnancy Outcomes for Mother and Fetus. Obstetrics & Gynecology 106:3, 517-524
CrossRef78
B. Brenner. (2005) Thrombophilia and pregnancy. Hematology 10:4, 186-189
CrossRef79
Benjamin Brenner. (2005) Thrombophilia in pregnancy and its role in abortion. Women's Health 1:1, 35-38
CrossRef80
Michael J. Paidas, De-Hui W. Ku, Jens Langhoff-Roos, Yale S. Arkel. (2005) Inherited Thrombophilias and Adverse Pregnancy Outcome: Screening and Management. Seminars in Perinatology 29:3, 150-163
CrossRef81
I. PABINGER, H. GRAFENHOFER, A. KAIDER, P. A. KYRLE, P. QUEHENBERGER, C. MANNHALTER, K. LECHNER. (2005) Risk of pregnancy-associated recurrent venous thromboembolism in women with a history of venous thrombosis. Journal of Thrombosis and Haemostasis 3:5, 949-954
CrossRef82
Clemens B Tempfer, Eva-Katrin Riener, Christoph Keck, Christoph Grimm, Georg Heinze, Johannes C Huber, Gerald Gitsch, Lukas A Hefler. (2005) Polymorphisms associated with thrombophilia and vascular homeostasis and the timing of menarche and menopause in 728 white women. Menopause 12:3, 325-330
CrossRef83
Lindsay Robertson, Ian Greer. (2005) Thromboembolism in pregnancy. Current Opinion in Obstetrics and Gynecology 17:2, 113-116
CrossRef84
J. A. HEIT, J. L. SOBELL, H. LI, S. S. SOMMER. (2005) The incidence of venous thromboembolism among Factor V Leiden carriers: a community-based cohort study. Journal of Thrombosis and Haemostasis 3:2, 305-311
CrossRef85
M. DEN HEIJER, S. LEWINGTON, R. CLARKE. (2005) Homocysteine, MTHFR and risk of venous thrombosis: a meta-analysis of published epidemiological studies. Journal of Thrombosis and Haemostasis 3:2, 292-299
CrossRef86
Andra H. James, Leo R. Brancazio. (2005) Prenatal Screening for Thrombophilia: The Background and the Approach. Gynecologic and Obstetric Investigation 60:1, 47-57
CrossRef87
Valentina Djordjevic, Ljiljana Rakicevic, Milos Spasic, Predrag Miljic, Danijela Mikovic, Mirjana Kovac, Dragica Radojkovic. (2005) Factor V Leiden, FII G20210A, MTHFR C677T mutations as risk factors for venous thrombosis during pregnancy and puerperium. Vojnosanitetski pregled 62:3, 201-205
CrossRef88
Lindsay Robertson, Olivia Wu, Ian Greer. (2004) Thrombophilia and adverse pregnancy outcome. Current Opinion in Obstetrics and Gynecology 16:6, 453-458
CrossRef89
Clemens B Tempfer, Eva-Katrin Riener, Lukas A Hefler, Christoph Keck. (2004) Genetic thrombophilia has pleiotropic effects in pregnancy. Personalized Medicine 1:1, 105-114
CrossRef90
Jody L. Kujovich. (2004) Hormones and pregnancy: thromboembolic risks for women. British Journal of Haematology 126:4, 443-454
CrossRef91
M. Paidas, D.-H. Ku, E. Triche, C. Lockwood, Y. Arkel. (2004) Does heparin therapy improve pregnancy outcome in patients with thrombophilias?. Journal of Thrombosis and Haemostasis 2:7, 1194-1195
CrossRef92
Brian S. Donahue. (2004) Factor V Leiden and Perioperative Risk. Anesthesia & Analgesia1623-1634
CrossRef93
Lisa Moores, Kathryn L Bilello, Susan Murin. (2004) Sex and gender issues and venous thromboembolism. Clinics in Chest Medicine 25:2, 281-297
CrossRef94
N DOYLE, M MONGA. (2004) Thromboembolic disease in pregnancy. Obstetrics and Gynecology Clinics of North America 31:2, 319-344
CrossRef95
E. Lindhoff-Last. (2004) Maternal thrombophilia and obstetric complications / Mütterliche Thrombophilie und geburtshilfliche Komplikationen. LaboratoriumsMedizin 28:1, 34-41
CrossRef96
(2004) Risk of venous thromboembolism during pregnancy in homozygous carriers of the factor V Leiden mutation: are there any predictive factors?. Journal of Thrombosis and Haemostasis 2:2, 359-360
CrossRef97
Noga Carmi, Dana Cohen, Eti Zvang, Elizabeth Naparstek, Varda Deutsch. (2004) Pronto
ThromboRisk??A novel primer-extension ELISA based assay for the detection of mutations associated with increased risk for thrombophilia. Journal of Clinical Laboratory Analysis 18:5, 259-264
CrossRef98
Gabriel S Gebhardt, David R Hall. (2003) Inherited and acquired thrombophilias and poor pregnancy outcome: should we be treating with heparin?. Current Opinion in Obstetrics and Gynecology 15:6, 501-506
CrossRef99
Douglas A Triplett, John A Penner. (2003) Comprehensive hypercoagulable state testing is indicated in patients with a first idiopathic deep venous thrombosis. Medical Clinics of North America 87:6, 1237-1250
CrossRef100
Meyer-Michel Samama, Roberto A. Rached, Marie-Hélène Horellou, Sandro Aquilanti, Valérie G. Mathieux, Geneviève Plu-Bureau, Ismail Elalamy, Jacqueline Conard. (2003) Pregnancy-associated venous thromboembolism (VTE) in combined heterozygous factor V Leiden (FVL) and prothrombin (FII) 20210 A mutation and in heterozygous FII single gene mutation alone. British Journal of Haematology 123:2, 327-334
CrossRef101
B. Brenner. (2003) Antithrombotic prophylaxis for women with thrombophilia and pregnancy complications - Yes. Journal of Thrombosis and Haemostasis 1:10, 2070-2072
CrossRef102
Robert H. Thomas, MD, FACP. (2003) science [hematology and coagulation]: Update on Thrombophilic Disorders. Laboratory Medicine 34:9, 672-679
CrossRef103
Michael A. Sloan, Barney J. Stern. (2003) Cerebrovascular disease in pregnancy. Current Treatment Options in Neurology 5:5, 391-407
CrossRef104
Diana Mertens. (2003) Antibody-Mediated Thrombosis and Pregnancy Loss. The Nurse Practitioner 28:7, 55-57
CrossRef105
J. S. Ginsberg, S. M. Bates. (2003) Management of venous thromboembolism during pregnancy. Journal of Thrombosis and Haemostasis 1:7, 1435-1442
CrossRef106
Tina Buchholz, Christian J. Thaler. (2003) Inherited Thrombophilia: Impact on Human Reproduction. American Journal of Reproductive Immunology 50:1, 20-32
CrossRef107
Marc A Rodger, Mark Walker, Philip S Wells. (2003) Diagnosis and treatment of venous thromboembolism in pregnancy. Best Practice & Research Clinical Haematology 16:2, 279-296
CrossRef108
Ian A Greer. (2003) Prevention of venous thromboembolism in pregnancy. Best Practice & Research Clinical Haematology 16:2, 261-278
CrossRef109
Rainer B Zotz, Andrea Gerhardt, Rüdiger E Scharf. (2003) Inherited thrombophilia and gestational venous thromboembolism. Best Practice & Research Clinical Haematology 16:2, 243-259
CrossRef110
Karl D. Lewis, Kathryn L. Hassell. (2003) Hypercoagulability. Primary Care Case Reviews 6:2, 57-66
CrossRef111
William M Hague, Gustaaf A Dekker. (2003) Risk factors for thrombosis in pregnancy. Best Practice & Research Clinical Haematology 16:2, 197-210
CrossRef112
Karl D. Lewis, Kathryn L. Hassell. (2003) Hypercoagulability: Proper Workup Following Deep Vein Thrombosis. Primary Care Case Reviews 6:2, 57-66
CrossRef113
L BOWLES, H COHEN. (2003) Inherited thrombophilias and anticoagulation in pregnancy. Best Practice & Research Clinical Obstetrics & Gynaecology 17:3, 471-489
CrossRef114
J SAID, G DEKKER. (2003) Pre-eclampsia and thrombophilia. Best Practice & Research Clinical Obstetrics & Gynaecology 17:3, 441-458
CrossRef115
G BUCHANAN, G RODGERS, D WAREBRANCH. (2003) The inherited thrombophilias: genetics, epidemiology, and laboratory evaluation. Best Practice & Research Clinical Obstetrics & Gynaecology 17:3, 397-411
CrossRef116
I GREER. (2003) Inherited thrombophilia and venous thromboembolism. Best Practice & Research Clinical Obstetrics & Gynaecology 17:3, 413-425
CrossRef117
Georg Endler, Christine Mannhalter. (2003) Polymorphisms in coagulation factor genes and their impact on arterial and venous thrombosis. Clinica Chimica Acta 330:1-2, 31-55
CrossRef118
Ian A Greer. (2003) Prevention and management of venous thromboembolism in pregnancy. Clinics in Chest Medicine 24:1, 123-137
CrossRef119
Stephanie L Perry, Thomas L Ortel. (2003) Clinical and laboratory evaluation of thrombophilia. Clinics in Chest Medicine 24:1, 153-170
CrossRef120
S. J. Machin. (2003) Pros and cons of thrombophilia testing: cons. Journal of Thrombosis and Haemostasis 1:3, 412-413
CrossRef121
Tetsuya Ishikawa, Teruo Okabe, Kazuo Ogawa, Jun Fuse, Yoko Oshiba, Akira Ono, Masao Chino. (2003) Usefulness of a Second Temporary Vena Cava Filter for Preventing Acute Pulmonary Thromboembolism. Circulation Journal 67:8, 718-720
CrossRef122
T Singh, T Chakera. (2002) Dural sinus thrombosis presenting as unilateral lobar haematomas with mass effect: An easily misdiagnosed cause of cerebral haemorrhage. Australasian Radiology 46:4, 351-365
CrossRef123
Shannon M Bates. (2002) Treatment and prophylaxis of venous thromboembolism during pregnancy. Thrombosis Research 108:2-3, 97-106
CrossRef124
Amy M. Adelberg, Jeffrey A. Kuller. (2002) Thrombophilias and Recurrent Miscarriage. Obstetrical & Gynecological Survey 57:10, 703-709
CrossRef125
B. Tutschek, S. Struve, T. Goecke, M. Pillny, R. Zotz, A. Gerhardt, M. Beckmann. (2002) Clinical risk factors for deep venous thrombosis in pregnancy and the puerperium. Journal of Perinatal Medicine 30:5, 367-370
CrossRef126
DONNA DIZON-TOWNSON. (2002) Pregnancy-Related Venous Thromboembolism. Clinical Obstetrics and Gynecology 45:2, 363-368
CrossRef127
W. Benson Harer. (2002) A Guest Editorial: Quo Vadis Cesarean Delivery?. Obstetrical and Gynecological Survey 57:2, 61-64
CrossRef128
T. Agorastos, A. Karavida, A. Lambropoulos, T. Constantinidis, S. Tzitzimikas, S. Chrisafi, H. Saravelos, D. Vavilis, A. Kotsis, J. Bontis. (2002) Factor V Leiden and prothrombin G20210A mutations in pregnancies with adverse outcome. Journal of Maternal-Fetal and Neonatal Medicine 12:4, 267-273
CrossRef129
J. Emmerich, M. Aiach. (2002) Facteurs génétiques de risque de thrombose. Annales de Cardiologie et d'Angéiologie 51:3, 129-134
CrossRef130
Ian A. Greer. (2001) The acute management of venous thromboembolism in pregnancy. Current Opinion in Obstetrics and Gynecology 13:6, 569-575
CrossRef131
Annalyn Gilchrist, Natalie Solomon, Dwight Erickson, Anita Sikand, Kenneth A Bauer, Margot S Kruskall, Olivier Kocher. (2001) Automated detection of the G20210A prothrombin mutation using the LCx® microparticle enzyme immunoassay. Clinica Chimica Acta 314:1-2, 249-254
CrossRef132
P GIBSON, K ROSENEMONTELLA. (2001) Anticoagulants. Best Practice & Research Clinical Obstetrics & Gynaecology 15:6, 847-861
CrossRef133
Marianne Van Rooijen, Katarina Bremme. (2001) A family history can display a synergistic effect of atherogenic and prothrombotic risk in pregnancy. Acta Obstetricia et Gynecologica Scandinavica 80:9, 873-874
CrossRef134
Norman M. Kaplan, Biff F. Palmer, Factor V Leiden:, Ray Lee. (2001) Southwestern Internal Medicine Conference. The American Journal of the Medical Sciences 322:2, 88-102
CrossRef135
I GREER, A THOMSON. (2001) Management of venous thromboembolism in pregnancy. Best Practice & Research Clinical Obstetrics & Gynaecology 15:4, 583-603
CrossRef136
Xiaobin Wang, Barry Zuckerman, Gary Kaufman, Paul Wise, Maria Hill, Tianhua Niu, Louise Ryan, Di Wu, Xiping Xu. (2001) Molecular epidemiology of preterm delivery: methodology and challenges. Paediatric and Perinatal Epidemiology 15:s2, 63-77
CrossRef137
J. T. Sprouse, C. S. Wong, W. L. Chandler, G. D. Williams, S. L. Watkins, P. I. Tarr. (2001) Thrombogenic alleles, Escherichia coli O157:H7 infections, and hemolytic uremic syndrome. Blood Coagulation and Fibrinolysis 12:4, 283-288
CrossRef138
Josip Djelmis, Marina Ivanisevic, Asim Kurjak, Davor Mayer. (2001) Hemostatic problems before, during and after delivery. Journal of Perinatal Medicine 29:3, 241-246
CrossRef139
Seligsohn, Uri, Lubetsky, Aharon, . (2001) Genetic Susceptibility to Venous Thrombosis. New England Journal of Medicine 344:16, 1222-1231
Full Text140
Daniela Matei, Benjamin Brenner, Victor J. Marder. (2001) Acquired thrombophilic syndromes. Blood Reviews 15:1, 31-48
CrossRef141
Janet M Shapiro. (2001) Venous Thromboembolism in Pregnancy. Journal of Intensive Care Medicine 16:1, 22-28
CrossRef142
Wendell W. Weber. (2001) Pharmacogenetic Tactics and Strategies. Paediatric Drugs 3:12, 863-881
CrossRef143
Benjamin Brenner. (2000) Inherited thrombophilia and fetal loss. Current Opinion in Hematology 7:5, 290-295
CrossRef144
(2000) Prothrombin and Factor V Mutations in Women with a History of Thrombosis during Pregnancy and the Puerperium. New England Journal of Medicine 342:26, 1996-1997
Full Text145
John R Higgins. (2000) Pregnancy and the impact of inherited thrombophilias. The Australian and New Zealand Journal of Obstetrics and Gynaecology 40:2, 118-121
CrossRef146
Greer, Ian A., . (2000) The Challenge of Thrombophilia in Maternal–Fetal Medicine. New England Journal of Medicine 342:6, 424-425
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