18 results on '"Scharrer I"'
Search Results
2. Thromboelastographic phenotypes of fibrinogen and its variants: Clinical and non-clinical implications
- Author
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Galanakis, D.K. Neerman-Arbez, M. Brennan, S. Rafailovich, M. Hyder, L. Travlou, O. Papadakis, E. Manco-Johnson, M.J. Henschen, A. Scharrer, I.
- Abstract
Introduction Thromboelastography (TEG), a widely used clinical point of care coagulation test, is poorly understood. To investigate its fibrin determinants we used normal and variant fibrinogen isolates. Materials and Methods We focused mainly on the TEG maximum signal amplitude (MA), a shear modulus and clot stiffness indicator. Isolates included normal des-αC, cord, and abnormal congenital variants with amino acid substitutions or deletions that impaired fibrin polymerization. Heterophenotypic congenital isolates were from cryoprecipitate-depleted plasma owing to their more diminished clot MA than their cryoprecipitate counterparts. By colorimetric assay, the amount of fibrinogen adsorbed by untreated TEG cups was 83.5 ± 12.4 pM/cm2, n = 18. Thrombin-induced clots were obtained at pH 6.4 or 7.4, the latter containing 8 mM CaCl2, and 14% afibrinogenemic plasma with and without gel-sieved platelets. Results and Conclusions Measured by the water droplet contact angle, > 90% reduction of surface hydrophobicity by exposure of TEG cup and pin to ozone plasma decreased MA by 74%. Increasing normal fibrinogen or thrombin concentrations progressively increased MA. Platelets increased MA further ~ 2 fold, except for ≥ 10 fold for des-αC clots. Examined in the absence of platelets, MA of heterophenotypic fibrin variants averaged 21%, n = 15. The results imply that essential MA determinants include hydrophobic fibrinogen/fibrin adsorption and each polymerization contact site, with substantial enhancement by platelets. Also, cryoprecipitate-harvested soluble fibrinogen/fibrin complexes contained mostly normal molecules, while cryoprecipitate-depleted plasma contained mostly variant molecules. Moreover, significantly decreased MA by fibrinogen anomalies and/or low level thrombin generation can potentially impact clinical interpretation of MA. © 2014 Elsevier Ltd. All rights reserved.
- Published
- 2014
3. Erworbene Hemmkörperhämophilie
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Scharrer I and Grossmann R
- Subjects
medicine.medical_specialty ,biology ,business.industry ,High mortality ,Autoantibody ,General Medicine ,Disease ,Haemophilia ,medicine.disease ,Gastroenterology ,Anesthesiology and Pain Medicine ,Recombinant factor VIIa ,Internal medicine ,Acquired haemophilia ,biology.protein ,Medicine ,In patient ,business ,Factor IX ,medicine.drug - Abstract
Although autoantibodies against factor VIII or factor IX are a rare phenomenon, they are associated with a high risk of bleeding and high mortality. The condition, termed acquired haemophilia, occurs equally in both sexes and is most frequent in higher age groups. Patients typically present with severe bleedings in muscles and skin. In contrast to patients with congenital haemophilia and inhibitors, joint bleedings are very rare. In approximately half of all cases an associated disease state can be identified as the cause of autoantibody formation. An immediate and comprehensive diagnosis is essential for a rapid initiation of therapy. Equally important are a careful diagnostic differentiation between congenital and acquired factor deficiencies and the exclusion of non-specific inhibitors, which increase the occurrence of thrombolic events. The inhibitor titre, quantified using the Bethesda assay, is an important criterion for selecting the appropriate therapy. A wide range of treatment options is now available for the management of bleedings in patients with acquired haemophilia, namely porcine factor VIII, recombinant factor VIIa, prothrombin complex concentrates, and immunoadsorptions. In addition, immunosuppressive therapies are used to achieve permanent reduction or elimination of inhibitors.
- Published
- 2000
4. A Multicenter Pharmacosurveillance Study for the Evaluation of the Efficacy and Safety of Recombinant Factor VIII in the Treatment of Patients with Hemophilia A
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Scharrer I and Aygören-Pürsün E
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medicine.medical_specialty ,biology ,Parvovirus ,business.industry ,Hematology ,biology.organism_classification ,medicine.disease ,Gastroenterology ,Recombinant factor viii ,law.invention ,Surgery ,Basal (phylogenetics) ,Multicenter study ,law ,hemic and lymphatic diseases ,Internal medicine ,Coagulopathy ,medicine ,Recombinant DNA ,Seroconversion ,business ,Previously treated - Abstract
SummaryIn this open multicenter study the safety and efficacy of recombinant factor VIII (rFVIII) was assessed in 39 previously treated patients with hemophilia A (factor VIII basal activity ≤15%).Recombinant FVIII was administered for prophylaxis and treatment of bleeding episodes and for surgical procedures. A total of 3679 infusions of rFVIII were given. Efficacy of rFVIII as assessed by subjective evaluation of response to infusion and mean annual consumption of rFVIII was comparable to that of plasma derived FVIII concentrates. The incremental recovery of FVIII (2.4 ± 0,83%/IU/kg, 2.12 ± 0.61%/IU/kg, resp.) was within the expected range. No clinical significant FVIII inhibitor was detected in this trial. Five of 16 susceptible patients showed a seroconversion for parvovirus B19. However, the results are ambiguous in two cases and might be explained otherwise in one further case. Thus, in two patients a reliable seroconversion for parvovirus B19 was observed.
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- 1997
5. Thrombophile Gerinnungsstörungen und venöse retinale Gefäßverschlüsse: Eine Subgruppenanalyse
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Kuhli-Hattenbach, C, Scharrer, I, and Hattenbach, LO
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ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Hintergrund: Venöse retinale Gefäßverschlüsse werden als Erkrankung des höheren Lebensalters angesehen und hauptsächlich auf kardiovaskuläre Risikofaktoren zurückgeführt. Demgegenüber wird die Bedeutung thrombophiler Gerinnungsstörungen noch immer[for full text, please go to the a.m. URL], 83. Versammlung der Vereinigung Rhein-Mainischer Augenärzte
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- 2010
- Full Text
- View/download PDF
6. Outcome and quality of life after surgical treatment of chronic subdural hematoma. How is it influenced by preoperative anticoagulation?
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Forster, MT, Senft, C, Scharrer, I, Seifert, V, and Gerlach, R
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ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Objective: To investigate the influence of perioperative anticoagulation on the clinical course, outcome, and quality of life (QoL) after surgical treatment of chronic subdural hematoma (CSDH). Methods: Medical data of 144 patients who underwent surgical evacuation of CSDH between January 2000 and[for full text, please go to the a.m. URL], 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien
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- 2009
- Full Text
- View/download PDF
7. ein Problem?
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Hochmuth, K, Huckschlag, N, Scharrer, I, Zichner, L, and Kurth, A
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ddc: 610 - Published
- 2004
8. Die TF- und TFPI-mRNA Expression ist höher in Glioblastomen als in low-grade-Gliomen und führt zu einer höheren TF- und TFPI-Proteinkonzentration in malignen Gliomen
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Gerlach, R, Barko, P, Demel, G, Böhm, M, Groß, U, Franz, K, Scharrer, I, and Seifert, V
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ddc: 610 - Published
- 2004
9. Impact of environmental and hereditary risk factors on the clinical manifestation of thrombophilia in homozygous carriers of factor V : G1691A
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Ehrenforth, S., Nemes, L., Mannhalter, C., Rosendaal, F.R., Koder, S., Zoghlami-Rintelen, C., Scharrer, I., and Pabinger, I.
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- 2004
10. Leg ulcers in Klinefelter's syndrome--further evidence for an involvement of plasminogen activator inhibitor-1
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Zollner, Thomas Matthias, Veraart, J. C., Wolter, Manfred, Hesse, S., Villemur, B., Wenke, A., Werner, R. J., Boehncke, Wolf-Henning, Jost, S. S., Scharrer, I., and Kaufmann, Roland
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Male ,Arterial Occlusive Diseases/complications/metabolism ,Fibrinolysis ,Leg Ulcer ,Smoking ,Plasminogen Activator Inhibitor 1/*metabolism ,Arterial Occlusive Diseases ,Middle Aged ,Body Mass Index ,Diabetes Mellitus/metabolism ,Diabetes Complications ,Klinefelter Syndrome ,Triglycerides/metabolism ,Leg Ulcer/*etiology/metabolism ,Hypertension ,Plasminogen Activator Inhibitor 1 ,Diabetes Mellitus ,Hypertension/complications/metabolism ,Humans ,Klinefelter Syndrome/*complications/metabolism ,Triglycerides - Abstract
An abnormality in platelet aggregability or fibrinolysis, namely elevated activity of plasminogen activator inhibitor-1 (PAI-1), has been recently documented in patients suffering from Klinefelter's syndrome associated with leg ulceration without underlying venous insufficiency. To determine whether increased PAI-1 activity is a general feature of Klinefelter's syndrome, or more specifically associated with leg ulceration, we investigated PAI-1 influencing parameters and PAI-1 activity in two groups of patients: (i) Klinefelter patients suffering from leg ulceration (n = 7); and (ii) Klinefelter patients without leg ulceration (n = 6). On analysing PAI-1 influencing parameters such as age, body mass index, triglycerides, C-reactive protein, testosterone, smoking behaviour, the presence of diabetes mellitus, and arterial hypertension, respectively, we found no statistically significant differences between the two groups. However, PAI-1 activity in group 1 was highly significantly elevated compared with that in group two patients (P < 0.005). We conclude that (i) PAI-1 activity is not elevated in Klinefelter's syndrome in general; (ii) elevation of PAI-1 activity in patients suffering from Klinefelter's syndrome does not appear to be secondary to PAI-1 influencing parameters; and (iii) elevation of PAI-1 activity may play a crucial role in the pathogenesis of leg ulceration in Klinefelter's syndrome. Therefore, a therapy for leg ulceration in Klinefelter's syndrome that aims to return the elevated PAI-1 activity to normal should be explored.
- Published
- 1997
11. DETERMINATION OF PLASMA PROTEIN-C INHIBITOR AND OF 2 ACTIVATED PROTEIN-C-INHIBITOR COMPLEXES IN NORMALS AND IN PATIENTS WITH INTRAVASCULAR COAGULATION AND THROMBOTIC DISEASE
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Espana, F., VICENTE, V, TABERNERO, D, SCHARRER, I, and GRIFFIN, JH
- Published
- 1990
12. Diagnostik und Behandlung von Gerinnungsstörungen in der operativen Orthopädie
- Author
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Scharrer I
- Subjects
medicine.medical_specialty ,Continuous infusion ,business.industry ,hemic and lymphatic diseases ,Orthopedic surgery ,Medicine ,Orthopedics and Sports Medicine ,Substitution therapy ,business ,Coagulation Disorder ,Surgery - Abstract
Patients suffering from von-Willebrand-disease or hemophilia A or B are the most common patients with coagulation disorders in orthopedic hospitals. Patients suffering from hemophilia A or B are treated with pure factor VIII or IX concentrates. We prefer recombinant products. The goals are normal levels of F VIII or F IX activity during the operation and postoperatively. In order to save costs the continuous infusion is recommended. Approximately 30% of products and costs may be saved. The prevalence of von-Willebrand-disease is very high in Europe and USA (1%). Typical presentation of these patients is the uncontrollable bleeding during an operation; typical is also the bleeding from mucous membranes. Patients with mild disorders are treated with DDAVP. Patients suffering from type 3 need substitution therapy with von-Willebrand-factor containing concentrates (for example Humate P).
- Published
- 1999
13. Crohnʼs Disease Activity
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Solem E, Zielen S, Hans Georg Posselt, Bender Sw, Kreuz W, and Scharrer I
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medicine.medical_specialty ,biology ,medicine.diagnostic_test ,business.industry ,C-reactive protein ,Gastroenterology ,Acute-phase protein ,Serum albumin ,Orosomucoid ,Inflammation ,Endocrinology ,Antigen ,Coagulation ,hemic and lymphatic diseases ,Internal medicine ,Erythrocyte sedimentation rate ,Pediatrics, Perinatology and Child Health ,medicine ,biology.protein ,medicine.symptom ,business - Abstract
Twenty-eight patients (mean age 13.5 years) with proven Crohn's disease were examined for factor VIII coagulation activity (VIII:C), factor VIII-related antigen (VIII R:Ag), and factor VIII-related ristocetin cofactor activity (VIII R:RCF). The factor VIII coagulation proteins were correlated with disease activity index according to van Hees and were compared with inflammatory parameters such as erythrocyte sedimentation rate, c-reactive protein, and orosomucoid. Among the factor VIII proteins, factor VIII-related protein (VIII R:Ag) correlates best with van Hees disease activity index, orosomucoid, c-reactive protein, and erythrocyte sedimentation rate (p less than 0.001 for all parameters). Since acute phase proteins are produced by liver cells, whereas VIII R:Ag is synthesized by endothelial cells, we postulate that this coagulation factor is highly sensitive in reflecting the inflammatory process in the intestine.
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- 1985
14. The International Registry of Immune Tolerance: 1994 update
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Ghirardini, A., maria Puopolo, Chiarotti, F., Mariani, G., Brettler, D. B., Peerlink, K., Beardsley, D. S., Bell, B. A., Berrettini, M., Blei, F., Ballocchi, A., Butler, R., Ciavarella, N., Ewing, N. P., Fressinaud, E., Gill, J., Gringeri, A., Growe, G. H., Guerois, C., Hilgartner, M., Kasper, C. K., Kisker, C. T., Inwood, M. J., Magallon, F., Johnson, M. M., Menza, L., Mauser-Bunschoten, E. P., Miller, R. T., Morfini, M., Nagao, T., Poon, M. C., Rasi, V., Rodeghiero, F., Rubin, S. H., Scharrer, I., Schimpf, K., Scheibel, E., Strawczyusky, H., Sultan, Y., Thompson, A. R., Tusell, J. M., White, G. C., Smith, P., and Walker, I.
15. Experiences with recombinant factor VIII products: development of inhibitors and immune tolerance therapy
- Author
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Scharrer I, Neutzling O, Schwaab R, Johannes Oldenburg, and Ehrlich H
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Factor VIII ,Humans ,Hemophilia A ,Recombinant Proteins
16. Risk of a first venous thrombotic event in carriers of a familial thrombophilic defect. The European Prospective Cohort on Thrombophilia (EPCOT)
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Peter Svensson, F. R. Rosendaal, Juan Carlos Souto, F. E. Preston, Michael Makris, J. Conard, I. Scharrer, F. J. M. Van Der Meer, Isobel D. Walker, C. Y. Vossen, Gualtiero Palareti, Jordi Fontcuberta, Ingrid Pabinger, VOSSEN CY, CONARD J, FONTCUBERTA J, MAKRIS M, VAN DER MEER FJ, PABINGER I, PALARETI G., PRESTON FE, SCHARRER I, SOUTO JC, SVENSSON P, WALKER ID, and ROSENDAAL FR
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medicine.medical_specialty ,business.industry ,Hematology ,medicine.disease ,Thrombophilia ,Thrombosis ,Asymptomatic ,Surgery ,Pulmonary embolism ,Venous thrombosis ,Internal medicine ,medicine ,Factor V Leiden ,Protein S deficiency ,medicine.symptom ,business ,Asymptomatic carrier - Abstract
Background. Reliable risk estimates for venous thrombosis in families with inherited thrombophilia are scarce but necessary for determining optimal screening and treatment policies. Objectives: In the present analysis, we determined the risk of a first venous thrombotic event in carriers of a thrombophilic defect (i.e. antithrombin-, protein C- or protein S deficiency, or factor V Leiden). Patients and methods: The asymptomatic carriers had been tested prior to this study in nine European thrombosis centers because of a symptomatic, carrier in the family, and were followed prospectively for 5.7 years on average between March 1994 and January 2001. Annually, data were recorded on the occurrence of risk situations for venous thrombosis and events (e.g. venous thrombosis, death). Results: Twenty-six of the 575 asymptomatic carriers (4.5%) and seven of the 1118 controls (0.6%) experienced a first deep venous thrombosis or pulmonary embolism during follow-up. Of these events, 58% occurred spontaneously in the carriers compared with 43% in the controls. The incidence of first events was 0.8% per year (95% CI 0.5-1.2) in the carriers compared with 0.1% per year (95% CI 0.0-0.2) in the controls. The highest incidence was associated with antithrombin deficiency or combined defects, and the lowest incidence with factor V Leiden. Conclusions: The incidence of venous events in asymptomatic individuals from thrombophilic families does not exceed the risk of bleeding associated with long-term anticoagulant treatment in the literature (1-3%). (Less)
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- 2005
17. Recurrence rate after a first venous thrombosis in patients with familial thrombophilia
- Author
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F. Eric Preston, Jacqueline Conard, Michael Makris, C. Y. Vossen, Jordi Fontcuberta, Gualtiero Palareti, Peter Svensson, Isobel D. Walker, Felix J. M. van der Meer, Juan Carlos Souto, I. Scharrer, Frits R. Rosendaal, Ingrid Pabinger, Vossen CY, Walker ID, Svensson P, Souto JC, Scharrer I, Preston FE, Palareti G, Pabinger I, van der Meer FJ, Makris M, Fontcuberta J, Conard J, and Rosendaal FR.
- Subjects
Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Adolescent ,Hemorrhage ,Thrombophilia ,Recurrence ,Risk Factors ,medicine ,Coagulopathy ,Factor V Leiden ,Humans ,Prospective Studies ,Sex Distribution ,Child ,Aged ,Venous Thrombosis ,business.industry ,Vascular disease ,Incidence ,Incidence (epidemiology) ,Antithrombin ,Anticoagulants ,Middle Aged ,medicine.disease ,Surgery ,Venous thrombosis ,Female ,Cardiology and Cardiovascular Medicine ,business ,Protein C ,Follow-Up Studies ,medicine.drug - Abstract
Objective— Few comprehensive data are available on the recurrence rate of venous thrombosis in carriers of thrombophilic defects from thrombophilic families. We prospectively determined the recurrence rate after a first venous thrombotic event in patients with familial thrombophilia attributable to factor V Leiden or deficiencies of protein C, S, or antithrombin. Methods and Results— Data were gathered during follow-up on the occurrence of risk situations, anticoagulation treatment, and events (eg, venous thrombosis, hemorrhage). Over a mean follow-up period of 5.6 years, 44 of the 180 patients with familial thrombophilia who did not use long-term anticoagulation experienced a recurrent venous thromboembolic event (5.0%/year; 95% CI 3.6 to 6.7) compared with 7 of the 124 patients on long-term anticoagulation (1.1%/year; 95% CI 0.4 to 2.2). Spontaneous events occurred less often in patients on long-term anticoagulation (57%) than in patients without long-term anticoagulation (75%). The highest recurrence rate was found among men with a deficiency in natural anticoagulants or multiple defects and women with antithrombin deficiency. Although long-term anticoagulation treatment decreased the incidence of recurrent events by 80%, it also resulted in a risk of major hemorrhage of 0.8% per year. Conclusions— Extra care after a first event is required for men with a deficiency in natural anticoagulants or multiple defects and women with antithrombin deficiency.
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- 2005
18. Hereditary thrombophilia and fetal loss: a prospective follow-up study
- Author
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Gualtiero Palareti, Michael Makris, J. Conard, Ingrid Pabinger, F. J. M. Van Der Meer, I. Scharrer, Jordi Fontcuberta, Isobel D. Walker, F. E. Preston, Frits R. Rosendaal, C. Y. Vossen, Peter Svensson, Juan Carlos Souto, VOSSEN CY, PRESTON FE, CONARD J, FONTCUBERTA J, MAKRIS M, VAN DER MEER FJ, PABINGER I, PALARETI G., SCHARRER I, SOUTO JC, SVENSSON P, WALKER ID, and ROSENDAAL FR
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Adult ,Risk ,medicine.medical_specialty ,Adolescent ,medicine.drug_class ,Placenta ,Premedication ,Thrombophilia ,Pregnancy ,Medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Fetal Death ,Gynecology ,Family Health ,business.industry ,Proportional hazards model ,Obstetrics ,Antithrombin ,Anticoagulant ,Pregnancy Outcome ,Anticoagulants ,Thrombosis ,Hematology ,medicine.disease ,Confidence interval ,Relative risk ,Drug Evaluation ,Regression Analysis ,Female ,business ,medicine.drug ,Follow-Up Studies - Abstract
Background: As the placental vessels are dependent on the normal balance of procoagulant and anticoagulant mechanisms, inherited thrombophilia may be associated with fetal loss. Objectives: We performed a prospective study to investigate the relation between inherited thrombophilia and fetal loss, and the influence of thromboprophylaxis on pregnancy outcome. Patients and methods: Women were enrolled in the European Prospective Cohort on Thrombophilia (EPCOT). These included women with factor (F)V Leiden or a deficiency of antithrombin, protein C or protein S. Controls were partners or acquaintances of thrombophilic individuals. A total of 191 women (131 with thrombophilia, 60 controls) had a pregnancy outcome during prospective follow-up. Risk of fetal loss and effect of thromboprophylaxis were estimated by frequency calculation and Cox regression modelling. Results: The risk of fetal loss appeared slightly increased in women with thrombophilia without a previous history of fetal loss who did not use any anticoagulants during pregnancy (7/39 vs. 7/51; relative risk 1.4; 95% confidence interval 0.4, 4.7). Per type of defect the relative risk varied only minimally from 1.4 for FV Leiden to 1.6 for antithrombin deficiency compared with control women. Prophylactic anticoagulant treatment during pregnancy in 83 women with thrombophilia differed greatly in type, dose and duration, precluding solid conclusions on the effect of thromboprophylaxis on fetal loss. No clear benefit of anticoagulant prophylaxis was apparent. Conclusions: Women with thrombophilia appear to have an increased risk of fetal loss, although the likelihood of a positive outcome is high in both women with thrombophilia and in controls.
- Published
- 2004
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