Assessment and management of high-risk pregnancies in women with thrombophilia.

Pregnancy is an acquired hypercoagulable state which can lead to gestational vascular complications especially in the presence of other prothrombotic risk factors. The use of anticoagulation for prevention of pregnancy complications in women with thrombophilia is becoming more frequent. Efficacy and safety issues of therapeutic and prophylactic regimens use and monitoring of LMWH therapy in pregnancy are discussed in this review. In addition, a scoring system for women with thrombophilia is proposed which includes severity of pregnancy outcomes, thrombotic history and type of thrombophilia. Validation of this scoring system has revealed a significant correlation between the proposed score and LMWH dosages that were prescribed to the studied pregnant women. Careful diagnosis, observation and monitoring can add significant benefit to LMWH therapy during pregnancy.