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Inherited thrombophilia and pregnancy outcome

Dr Joanne Said, Prof John Higgins, Dr Eric Moses, Prof Shaun Brennecke, Dr Paul Monagle

Several disorders of the clotting system have been identified which predispose people to blood clots in their leg veins and other parts of the body. Collectively these disorders have been called thrombophilias. A relationship between thrombophilia and pregnancy complications such as preeclampsia (toxaemia of pregnancy), intrauterine growth restriction (baby growing less than expected during pregnancy), stillbirth (unexpected death of the baby in the womb) and placental abruption (bleeding from behind the placenta) has been suggested recently in a number of studies. The placentas of patients with pregnancy complications often contain blood clots so it is possible that patients who have a condition that predisposes them to blood clots may be more likely to get blood clots in the placenta and hence develop pregnancy complications. These pregnancy complications are major contributions to perinatal and maternal morbidity and mortality.

TIPPS: Thrombophilia in Pregnancy Prophylaxis Study

Dr Joanne Said, Ms Carmel Jeffers
Local co-ordinators of the multi-centre TIPPS trial, which is based at the Ottawa Hospital Research Institute in Canada and led by the chief investigator Dr Marc Rodger

The TIPPS trial seeks to determine the safety and effectiveness of low-molecular-weight heparin (LMWH), an anticoagulant, in preventing placenta mediated pregnancy complications and venous thromboembolism (VTE) in women with thrombophilia. Thus, the principal research question is: can LMWH prevent thrombosis in the leg veins, pulmonary arteries and placental vessels, thereby reducing the risk of deep vein thrombosis, pulmonary embolism, intrauterine growth restriction (IUGR), preeclampsia, miscarriage and stillbirth?

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