The utility of thrombophilia testing in pregnant women with thrombosis: fact or fiction?

Women who either present with an episode of acute venous thrombosis in pregnancy or who have a history of venous thrombosis who present for prenatal care often undergo testing for inherited thrombophilia. The rationale for screening may include questions about whether screening for inherited thrombophilias can help to alter anticoagulation plans in a pregnancy complicated by venous thrombosis, whether patients with a history of venous thrombosis who present for care in a subsequent pregnancy require anticoagulation and at what intensity, whether knowledge of thrombophilia changes the duration and intensity of anticoagulation outside pregnancy, and whether screening of family members is warranted. Data regarding these issues are reviewed, controversies surrounding thrombophilia testing in this setting are discussed, and clinical recommendations are made.