2025 Volume 66 Issue 6 Pages 495-503
Inherited thrombophilia is a rare disorder that increases risk of thrombotic events. The risk of venous thromboembolism (VTE) increases during pregnancy and the postpartum period. Type I antithrombin (AT) deficiency in particular confers a higher risk compared to protein C (PC) or protein S (PS) deficiency. Comprehensive assessment of VTE risk is recommended for pregnant women with hereditary thrombophilia, and should include the type of thrombophilia (AT/PC/PS deficiency), subtype (type I/type II), site of the genetic mutation, prior history of VTE, family history, and other existing or pregnancy-specific risk factors. However, aspects of management during pregnancy, such as the necessity of prophylactic anticoagulation therapy, the appropriate dosing of heparin, and the role of AT replacement therapy, remain insufficiently defined due to limited research data. Heparin is the first-line drug for both prevention and treatment of VTE. In patients with a history of VTE, therapeutic-dose heparin is recommended throughout pregnancy and the postpartum period.
