Incidence and clinical impact of inherited thrombophilia in second trimester pregnancies with abnormal uterine Doppler

Objective: Abnormal uterine perfusion in second trimester is one of the main prognostic indicators for complications in pregnancy such as preeclampsia and IUGR. As inherited thrombophilia is also associated with an increased risk for these complications, this study was to evaluate if these two parameters show any association regarding perinatal outcome and whether thrombophilia can be used as a further criterion for risk assessment.

Methods: 137 singleton pregnancies between week 18–26 were included in this retrospective study. All women were characterized by an abnormal uterine perfusion (mean pulsatility index of both uterine arteries >1.4 and/or bilateral notching). All women were tested for inherited thrombophilia – mutations of factor II (prothrombin) and factor V Leiden.

Results: Out of all 137 women, 6% showed a heterozygous factor-V-mutation, 3% a heterozygous prothrombin mutation, and 1.5% a heterozygous mutation of both factors. An association between the grade of abnormality of uterine perfusion and the occurrence of thrombophilia could not be detected. Of 125 pregnancies where perinatal outcome was recorded, 59 (46.8%) showed any kind of complication. No difference could be found in the incidence of complications in women with and without inherited thrombophilia.

Conclusion: In second trimester pregnancies with abnormal uterine perfusion, the finding of inherited thrombophilia does not have impact on the clinical outcome of these high-risk pregnancies. Therefore thromophilic status cannot serve as an additional prognostic indicator for later complications. In this pre-selected group with abnormal uterine perfusion inherited thrombophilia was not found more often than in normal healthy population.