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Thrombophilia is a group of genetical disorders that cause blood to clot abnormally. Thrombophilia is linked to recurrent pregnancy loss, foetal growth restriction, late miscarriages, stillbirth and preeclampsia. Clinicians usually apply the term thrombophilia only to patients with atypical thrombosis. A successful outcome of pregnancy requires an efficient uteroplacental circulation. Since this system may be compromised by disorders associated with a prothrombotic state, it was postulated that maternal thrombophilia might be a risk factor for preeclampsia and intrauterine growth retardation. The study included 459 pregnant women with gestational ages ranging from 14 weeks to 28 weeks and the patients in the study were tested for hereditary thrombophilia. The type of thrombophilic mutation most common found was the MTHFR mutation (25.7%), followed by the prothrombin gene mutation (20.9%) and the Leiden factor V mutation (15.7%). Also 15.03% patients had been diagnosed with preeclampsia and 6.75% of the pregnant women had IUGR fetuses. [ABSTRACT FROM AUTHOR]

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Pregnancy incidence in patients affected by chronic kidney disease (CKD) is increasing, despite the fact that renal disease is associated with high maternal and fetal morbidity. From an obstetrical perspective, the main complications for the developing pregnancy are often represented by preeclampsia or preterm delivery, in addition to the progression of their underlying renal dysfunction on a continuously increasing physiologic demands. If a pregnancy is considered, preconception counseling is advised. The lower the stage of CKD, the safer it is to consider in conceiving; however, in recent years, pregnancy in advanced or end-stage renal disease (ESRD), while on dialysis, is not a rare event, as overall outcome for those with advanced CKD has improved over time. The final risk of negative maternal-fetal outcomes is inversely related to renal function and increases with proteinuria. A multidisciplinary approach involving obstetricians, nephrologists and also neonatologists is needed in order to improve pregnancy outcomes in women with chronic kidney disease. The frequency of nephrological and obstetrical examination for pregnant CKD patients should be individualized for each patient. [ABSTRACT FROM AUTHOR]

A normal pregnancy progression leads towards a prothrombotic phenotype in order to prepare the mother for delivery. When the physiological adaptation overlaps to abnormal changes, such as thrombophilic factor mutations, the risk for adverse pregnancy outcome becomes increasingly higher. Doppler ultrasound velocimetry of utero-placental and fetal vessels represents a method of antenatal monitoring, thus being a noninvasive evaluation method. We analyzed 145 pregnant women, recruited over a period of 6 months, from January 2016 to June 2016, in the Obstetrics and Gynecology Department of the Bucharest University Emergency Hospital, who underwent clinical and ultrasound evaluation according to their gestational age. We encountered five cases with middle cerebral artery/ umbilical artery pulsatility indices ratio smaller than 1, representing the population at risk for a higher maternal and fetal morbidity and mortality. Also, intrauterine growth restriction was more frequent in the aforementioned group (60%) versus the rest of the patients (7.9%). An extensive literature review highlights the role of inherited thrombophilic disorders and obstetric complications affecting the normal placental vascular function; however, appropriate treatment can improve pregnancy outcome. Future research regarding thrombophilic pregnant patients should focus on close clinical and ultrasound monitoring for the best maternal and fetal results. [ABSTRACT FROM AUTHOR]

Methods to prevent the development of pathologies due to placental dysfunctions, such as gestational hypertension and preeclampsia, are the main approaches for obtaining the best maternal and fetal antepartum and postpartum prognosis. During 5 years of study (January, 2015 to December, 2019), the cases of pregnancy and puerperium complicated with pathology due to placental dysfunction were analyzed. The main objective was to determine the magnitude of the impact of thrombophilia on the development of an entity of gestational hypertension disorder. We compared the impact of thrombophilia and its associated complications in patients with gestational hypertension with moderate and severe preeclampsia. Thus, we found obesity, thrombophilia, and underlying cardiac pathology to be significant risk factors for severe preeclampsia. Regarding the comparative analysis of the risk factors and complications associated with patients with mild preeclampsia compared with those with severe preeclampsia, the presence in severe preeclampsia of thrombophilia, endocrine, liver, and cardiac pathology was higher and, a higher rate of complications was observed; complications included fetal death, intrauterine growth restriction (IUGR), prematurity, fetal arrhythmia with acute fetal distress, HELLP syndrome, and placental abruption. Thrombophilia has a significant effect on the development of severe preeclampsia, and oligohydramnios as specific complication of mild preeclampsia. Factors indicating an increased risk of progression from mild preeclampsia to severe preeclampsia are in addition to inherited thrombophilia the underlying pathologies, namely cardiac, hepatic, and endocrine factors. [ABSTRACT FROM AUTHOR]