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Association between hereditary thrombophilias and pregnancy loss: update 2005 Volume 12, issue 3, Juin 2006

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Authors
Laboratoire d’hématologie, groupe hospitalo-universitaire Caremeau, place du Pr Robert Debré, 30029 Nîmes Cedex 9, Consultation multidisciplinaire de médecine vasculaire, Département de gynécologie obstétrique, centre hospitalier universitaire, groupe hospitalo-universitaire Caremeau, Nîmes, Laboratoire d’hématologie, UFR des sciences pharmaceutiques et biologiques, EA 2992, université de Montpellier 1

The correlation between hereditary thrombophilia and fetal loss is supported by several observations. In murine models, the protein C system is essential for the maintenance of pregnancy, as it indirectly acts as a growth factor for trophoblast cells and protects them from apoptosis. In humans, the placenta replaces the yolk sac as an essential source of blood supply to the embryo during the 8 th and 9 th weeks of gestation. Furthermore, meta-analysis of epidemiological data demonstrates a correlation between thrombophilic polymorphisms such as factor V Leiden and prothrombin 20210G>A and isolated or recurrent fetal losses. Finally, therapeutic non-controlled trials indicate the benefits and safety of low-molecular weight heparins as secondary prophylaxis. However, it is still necessary to further clarify the association between thrombophilia and fetal loss, with regard to the type of pregnancy loss and with respect to other related factors.