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ASH: Pregnancy Loss Studied in Gene-Mutation Carriers

Factor V Leiden, prothrombin 20210A mutations don't preclude second, successful pregnancy

TUESDAY, Dec. 12 (HealthDay News) -- Among women who miscarry during a first pregnancy, the chances of a successful subsequent pregnancy are comparable between carriers and non-carriers of factor V Leiden and prothrombin 20210A mutations. The treatment of carriers with anticoagulant drugs such as low-molecular-weight heparin to prevent a second miscarriage should not be initiated until ongoing studies show its efficacy and safety, according to research presented this week at the 48th Annual Meeting of the American Society of Hematology in Orlando.

Michiel Coppens, M.D., of the Academic Medical Center in Amsterdam, the Netherlands, and colleagues studied 993 women, including 498 carriers, who had 2,809 pregnancies.

In women who experienced early loss during a first pregnancy, the researchers found that the live birth rates for the second pregnancy were 77 percent in carriers and 76 percent in non-carriers. In women who experienced late loss during a first pregnancy, rates were 68 percent in carriers and 80 percent in non-carriers.

"Given the observed favorable prognosis after a first pregnancy loss even in women with known thrombophilia and a late loss, low-molecular-weight heparin to improve pregnancy outcome should not be used before results from ongoing randomized placebo-controlled trials have shown its effectiveness and safety," the authors conclude.

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