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Use of selective factor V Leiden screening in pregnancy to identify candidates for anticoagulants.

Lindqvist, Pelle LU ; Olofsson, Per and Dahlbäck, Björn (2002) In Obstetrics and Gynecology 100(2). p.332-336
Abstract
OBJECTIVE: To improve identification of gravidas at risk for thrombosis. Venous thromboembolic complications are a major cause of maternal mortality during pregnancy. Factor V Leiden, which causes activated protein C resistance, is the most prevalent thrombophilia in white populations. However, selective screening for factor V Leiden has not been evaluated previously for identifying women who might benefit from anticoagulant prophylaxis during pregnancy. METHODS: We constructed a risk score based on major risk factors such as overweight, family history of thrombosis, previous thrombosis, cesarean delivery, and preeclampsia. A cohort of 2384 women with known factor V Leiden status was studied. Using the risk score and its distribution, we... (More)
OBJECTIVE: To improve identification of gravidas at risk for thrombosis. Venous thromboembolic complications are a major cause of maternal mortality during pregnancy. Factor V Leiden, which causes activated protein C resistance, is the most prevalent thrombophilia in white populations. However, selective screening for factor V Leiden has not been evaluated previously for identifying women who might benefit from anticoagulant prophylaxis during pregnancy. METHODS: We constructed a risk score based on major risk factors such as overweight, family history of thrombosis, previous thrombosis, cesarean delivery, and preeclampsia. A cohort of 2384 women with known factor V Leiden status was studied. Using the risk score and its distribution, we explored possible strategies of doing selective testing for factor V Leiden and their consequences. RESULTS: During the postpartum period, but not antepartum, there is a possibility of identifying women at similar risk as those with a history of thrombosis. Women with a risk score of 2 (4% of women, 0.2% risk of thrombosis) would be screened for factor V Leiden, and those with a resulting risk score of at least 3 (ie, 1.2% risk of thrombosis) would be treated for 6 weeks. Theoretically, for every 83 women treated at this risk level, one thrombotic episode might be prevented. CONCLUSION: By using a risk score, a subgroup of women who could benefit from selective factor V Leiden screening were identified postpartum. (Less)
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author
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published
subject
keywords
Mass Screening, Predictive Value of Tests, Prenatal Care, Pregnancy, Prenatal Diagnosis : methods, Primary Prevention : methods, Reference Values, Risk Assessment, Thrombosis : prevention & control, Thrombosis : blood, Sweden, Non-U.S. Gov't, Support, Risk Factors, Sensitivity and Specificity, Female, Human, Factor V : analysis, Adult, Anticoagulants : administration & dosage, Biological Markers : blood, Cohort Studies, Comparative Study
in
Obstetrics and Gynecology
volume
100
issue
2
pages
332 - 336
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:12151159
  • wos:000177151700022
  • scopus:0036334785
ISSN
1873-233X
language
English
LU publication?
yes
id
1b39607f-dd66-47e0-84e7-c9cc6c695464 (old id 109692)
alternative location
http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12151159&dopt=Abstract
date added to LUP
2007-07-26 08:38:31
date last changed
2017-08-06 04:24:32
@article{1b39607f-dd66-47e0-84e7-c9cc6c695464,
  abstract     = {OBJECTIVE: To improve identification of gravidas at risk for thrombosis. Venous thromboembolic complications are a major cause of maternal mortality during pregnancy. Factor V Leiden, which causes activated protein C resistance, is the most prevalent thrombophilia in white populations. However, selective screening for factor V Leiden has not been evaluated previously for identifying women who might benefit from anticoagulant prophylaxis during pregnancy. METHODS: We constructed a risk score based on major risk factors such as overweight, family history of thrombosis, previous thrombosis, cesarean delivery, and preeclampsia. A cohort of 2384 women with known factor V Leiden status was studied. Using the risk score and its distribution, we explored possible strategies of doing selective testing for factor V Leiden and their consequences. RESULTS: During the postpartum period, but not antepartum, there is a possibility of identifying women at similar risk as those with a history of thrombosis. Women with a risk score of 2 (4% of women, 0.2% risk of thrombosis) would be screened for factor V Leiden, and those with a resulting risk score of at least 3 (ie, 1.2% risk of thrombosis) would be treated for 6 weeks. Theoretically, for every 83 women treated at this risk level, one thrombotic episode might be prevented. CONCLUSION: By using a risk score, a subgroup of women who could benefit from selective factor V Leiden screening were identified postpartum.},
  author       = {Lindqvist, Pelle and Olofsson, Per and Dahlbäck, Björn},
  issn         = {1873-233X},
  keyword      = {Mass Screening,Predictive Value of Tests,Prenatal Care,Pregnancy,Prenatal Diagnosis : methods,Primary Prevention : methods,Reference Values,Risk Assessment,Thrombosis : prevention & control,Thrombosis : blood,Sweden,Non-U.S. Gov't,Support,Risk Factors,Sensitivity and Specificity,Female,Human,Factor V : analysis,Adult,Anticoagulants : administration & dosage,Biological Markers : blood,Cohort Studies,Comparative Study},
  language     = {eng},
  number       = {2},
  pages        = {332--336},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Obstetrics and Gynecology},
  title        = {Use of selective factor V Leiden screening in pregnancy to identify candidates for anticoagulants.},
  volume       = {100},
  year         = {2002},
}