Congenital and acquired thrombophilia, thrombophilia during pregnancy – treatment and risks

Like any other disease, thrombophilia appears with a number of concomitant factors.

Early detection of the disease has a positive effect on the formation of preventive measures:

  • food;
  • vitamin therapy;
  • taking anticoagulants;
  • rejection of bad habits.

All these measures are formed for each person individually, depending on laboratory parameters.

People with the same genotype may feel different depending on living conditions.

In time, the data obtained make it possible to prevent the manifestation of the disease, but you must remember:

  1. Thrombophilia as a disease only affects the appearance of the first acute thrombosis.
  2. Relapse of thrombosis associated with pathology occurs only in 10% of cases, and mainly depends on provoking factors.
  3. Not always hereditary thrombophilia proceeds in isolation, the manifestation of combined mutations is a very common phenomenon.
  4. The appearance of signs of thrombosis in adolescence or childhood is most often associated with hereditary mutations.
  5. Prevention of recurrence of thrombosis with thrombophilia by taking anticoagulants is not always justified.
  6. Thrombophilia genes can be detected at any age, there are no contraindications for analysis.
  7. Age is a factor influencing the appearance of thrombotic complications, therefore recurring thrombosis in old age cannot be associated only with genetic heredity.
  8. The study of genes with mutations has been going on for years, and the identification of new types of mutations is not excluded.
  9. Thrombophilia is not treated. Preventive measures only prevent the appearance of thromboembolism, but do not eliminate gene mutations.

Types of diseases

Thrombophilia can have a variety of manifestations. In most cases, the pathological process is asymptomatic. When certain factors occur, the process of the disease progresses. In most cases, exacerbation is observed against the background of:

  • Pregnancy;
  • Injuries
  • Surgical interventions;
  • Immobilization of the limbs.

Thrombophilia has several varieties. It can be hereditary or congenital, as well as acquired. The cause of the latter type of disease is injuries and surgical interventions. Genetic thrombophilia can be inherited or appear against a background of mutations.

Thrombophilia, depending on the cause of the occurrence, can be vascular, hemodynamic, hemotogenic.

  • The vascular type of the disease in most cases develops as a result of the course of vascularitis, atherosclerosis, etc.
  • The hemodynamic appearance occurs against the background of disorders in the hematopoiesis system.
  • The hemotogenic type of the disease appears when coagulation, anticoagulation, fibronolytic systems change. This type of disease belongs to the category of the most dangerous, which is explained by the possibility of developing a patient’s disability or death.

Hereditary thrombophilia and pregnancy are often combined. That is why it is necessary to be very careful about your health during the period of bearing the baby.

There are many types of thrombophilia, depending on various factors, for example:

  • By the type of vessels that were susceptible to the disease (i.e. arteries, veins, capillaries, as well as a mixed type).
  • By reason of occurrence (heredity or acquisition).
  • By course (due to improper circulation, change or damage to the walls of blood vessels and arteries).

If blood circulates incorrectly in the body, not all organs receive the dose of oxygen they need, and this affects both the state of the mother and the development of the child, which is disastrously disrupted. Thus, blood circulation between mother and child is irregular and irregular. In a particularly severe case, there is even a chance of a fading pregnancy.

Diet for thrombophilia during pregnancy

Nutrition for thrombophilia during pregnancy should, first of all, be healthy. as such does not exist. To dilute blood, it is advised to drink up to 2 liters of fluid per day. Most of the drunk liquid should be quality water.

Prohibited foods are chocolate, grapes, and. It is necessary to limit the use of cottage cheese, eggs and products with their content, nuts. For thrombophilia during pregnancy, include foods that help thin the blood:

  • dried fruits, berries and stewed fruits thereof;
  • seafood (just don’t need to be too zealous with them, their regular appearance on the menu 2-3 times a week is enough).

If hematogenous thrombophilia is caused by mutations in the folate cycle, use the power of natural folic acid, which is rich in green injection plants (vegetables): cabbage, lettuce, onions, garden herbs.

With the disease, a special antithrombotic diet is prescribed. It is necessary to limit foods that can increase blood viscosity. Diet should exclude the following foods:

  • lard, fatty meat, rich broth;
  • chocolate;
  • whole milk;
  • beans;
  • beef liver;
  • hard cheese
  • coffee, a large amount of green tea;
  • celery, parsley, spinach;
  • Do not eat sharp and fatty foods.

It is advisable to use those products that reduce blood coagulation:

  • cranberries, viburnum, lingonberries, aronia;
  • seafood;
  • ginger;
  • sea ​​kale;
  • red fruit drinks and juices;
  • cereal cereals – pearl barley, oat, barley, buckwheat,
  • dried fruits – dates, dried apricots, figs, raisins, prunes.

Forecast

Diet for thrombophilia

Proper nutrition is a fairly important fact in the treatment of the disease during pregnancy. Food products that increase blood viscosity are excluded from the patient’s diet. Women are strictly forbidden to use lard, rich broths and fatty meat. The patient menu should not consist of chocolate and whole milk.

It is strictly forbidden with thrombophilia to cook spicy and fatty dishes. Patients should not eat legumes and beef liver. During the development of the disease, the use of parsley, spinach, celery is not recommended. Hard cheese is excluded from the patient’s diet. Large quantities of coffee and green tea are also not worth drinking.

During the treatment of the disease, the use of products that reduce blood coagulation is recommended. The diet of the patient should include aronia, cranberries, cranberries, viburnum. Seafood is also recommended for the fairer sex. She is advised to drink ginger tea.

During the development of a diet for pregnant women, doctors without fail include red juice or juice. Sea kale has a beneficial effect on a woman’s condition during the treatment of thrombophilia. The pregnant menu should consist of dried fruits – raisins, prunes, figs, dried apricots, dates. It is also necessary to prepare cereal cereals – barley, pearl barley, buckwheat, oatmeal.

If a representative of the weaker sex will strictly follow a diet, this will eliminate the possibility of complications during pregnancy.

Forecast

Thrombophilia treatment – drugs and diet

Forecast

It is aimed at replenishing the missing coagulation factors by injection or plasma transfusion. With hyperaggregation, plasmapheresis and drip administration of plasma are indicated.

Acquired forms of thrombophilia are treated with anticoagulants. An indication for their purpose is a combination of 3 or more risk factors. With thrombophilia, the same drugs are used as for the treatment of thrombosis:

  • aspirin;
  • warfarin;
  • chimes;
  • pradaxa;
  • heparin and its derivatives (dalteparin, enoxaparin, fraxiparin).

People with thrombophilia are shown the use of folk remedies that thin the blood. Ginger, fresh grape juice, cranberry tea, dried fruits, and seafood are especially useful. Fatty and fried foods should be excluded from the diet, since the lipids in its composition thicken the blood.

Forecast

Thrombophilia is not a disease, but a predisposition to it. If you adhere to the basic rules of prevention, thrombosis and related complications (thromboembolism, ischemia, heart attack, stroke) will not develop.

First of all, you need to follow the principles of proper nutrition: include in the diet fresh vegetables, fruits, berries, seafood, low-fat varieties of meat and fish, whole grain bread. No need for stagnation of blood in the veins, which contributes to a sedentary lifestyle.

All chronic pathologies and acute infectious processes should be treated immediately or controlled. Systematic administration of hormonal drugs and replacement therapy for thrombophilia involve regular studies of blood coagulation ability.

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Postpartum Thrombophilia Treatment

Treatment for mild degrees of thrombophilia consists in taking blood thinners. The patient is shown such drugs as Acenocumarol, Warfarin. A special diet is also prescribed: foods that contribute to blood clotting are excluded from the diet. It is forbidden to consume green tea, spinach, salad, fatty nuts (walnuts, cashews) and liver of any origin.

  • If blood clots continue to form actively, the patient is hospitalized, and therapy is prescribed based on the intravenous administration of unfractionated heparin (using an infusomat, a special device dosed with the drug).
  • If the body of a person with thrombophilia does not perceive or negatively reacts to heparin structures, he is prescribed alternative therapy with sodium enoxaparin or fondaparinux.

Successfully used drugs with acetylsalicylic acid, dipyridamole, pentoxifylline, clopidogrel. As part of complex therapy, vitamins of group B, E, folic acid, alprostadil and nicotinic acid should be present.

In case of acute need, the patient is shown a surgical operation, during which the vessels are “cleaned” of blood clots by hand. After the procedure, it is necessary to take blood-thinning drugs for at least another 2-3 weeks.

Pregnant women are given a similar treatment for thrombophilia, but the number of prescribed medications is much less. Expectant mothers are encouraged to minimize physical activity and follow a diet.

Forecast

Thrombophilia is only a predisposition to the formation of blood clots, and if the patient follows the recommendations regarding nutrition and taking preventive drugs, the risks of stroke and heart attack are minimal.

Thrombophilia during pregnancy as a diagnosis can be made in the following cases:

  • upon detection of a Leiden mutation;
  • with prothrombin mutation;
  • mutation in all three genes of the folate cycle;
  • 3 or more homozygous forms of gene polymorphism;
  • 5 or more heterozygous forms.

Congenital Thrombophilia in Pregnancy
even after a diagnosis is not always required treatment. The decision to prescribe drugs is made if there are indicators in the peripheral blood that indicate increased blood coagulation. If there are no deviations, the management of pregnancy with thrombophilia is the same as with a normal pregnancy.

They begin treatment of thrombophilia during the preparation of pregnancy in the cycle when it is planned to conceive a child immediately after ovulation. Timely treatment that has been started allows not only to maintain pregnancy, but also to minimize risks for the baby.

With high markers of thrombophilia, immediately after ovulation, the administration of low molecular weight heparins (LMWH) begins – Fraxiparin (calcium nadroparin), Clexane (enoxaparin Na). The dose of drugs is calculated in accordance with the hemostasiogram. The drug is administered subcutaneously at 0,3-0,6 mg. The frequency of administration can be from 1 injection per day to 3.

With homocysteinemia, folic acid is taken in large doses – from 4 to 6 mg per day. Against this background, treatment with vitamins of group B is carried out (B6, B12).

If the platelet level is increased, then acetylsalicylic acid (Aspirin, Cardiomagnyl) is additionally prescribed at a dose of 75-100 mg per day, or Dipyridamole (Curantil). 75-150 mg per day (from 3 to 6-9 tablets).

The basic drugs for the treatment of thrombophilia during pregnancy are Fragmin, Clexane. They will need to be administered almost until the end of pregnancy. In the second half of pregnancy, the dose of LMWH rises to 60-80 mg per day. This is necessary, since at this time and during physiological pregnancy, an increase in the blood coagulation function occurs. Be sure to prescribe medications under the control of a coagulogram. An analysis is given 1 time in 3 weeks.

Cancellation of treatment should be carried out 1-2 days before the expected date of birth or planned surgical delivery (Caesarean section). It’s easier when doctors know the exact date of the Caesarean section. What to do if with congenital thrombophilia a natural birth is expected?

First of all, hospitalization is needed. If the drugs are canceled, but the birth does not occur, monitoring of the condition of the mother and fetus is required. Be sure to do a cardiotachogram of the fetus 1 time in 3 days. After 3 days of discontinuation of blood-thinning drugs, hemostasiogram indicators and markers of thrombosis should be checked. If the indicators of the analysis will increase, then the birth will have to be induced (stimulated).

Such concepts as thrombophilia and pregnancy planning, if they are interconnected, require the following treatment:

  • wearing an elastic bandage and compression underwear;
  • avoidance of prolonged standing or sitting;
  • massage;
  • swimming;
  • phytotherapy;
  • proper nutrition;
  • electromagnetic therapy.

If this pathology is detected in a pregnant woman, it is necessary to move more. Since physical inactivity can cause thrombophilia. Pregnant women in the first stages of pregnancy are allowed to massage. In any trimester, you can do preventive gymnastics, which will strengthen the muscles. Swimming is also shown. All this will have a beneficial effect on the course of pregnancy.

What does the doctor do

The doctor examines the patient. Gathers a medical history. Conducts laboratory tests for an accurate diagnosis, as well as for differentiation with other diseases. After all the necessary manipulations, the doctor prescribes treatment according to the duration of the pregnancy.

Treatment of thrombophilia begins with the selection of a qualified doctor, its goal is to eliminate thrombotic complications.

Medications are prescribed:

  • anticoagulants (low molecular weight heparins) that lower blood coagulation;
  • antiplatelet agents for the prevention of thromboembolism;
  • drugs that improve liver function;
  • fibrinolytic agents;
  • folic ac >

To prevent complications, it is recommended to use preventive measures. This is especially true of the period of pregnancy:

  • physical therapy classes;
  • lack of lifting weights, prolonged standing;
  • wearing medical compression hosiery or elastic bandages;
  • swimming;
  • electromagnetic therapy;
  • self-massage;
  • proper nutrition;
  • phytotherapy.

With thrombophilia, it is recommended to do the following exercise: lying on your back, raise and lower your legs without sudden movements. It is possible to use hirudotherapy, where special medical leeches are used.

Thrombophilia Treatment During Pregnancy

Often, it is during the expectation of a child that genetic thrombophilia manifests itself, therefore, treatment of pregnant women with this diagnosis should be started as early as possible. In this case, approximately the same drugs are used as for other categories. In practice, the following main and auxiliary medications are used:

  • Aescin;
  • Nadroparin calcium;
  • Troxerutin;
  • Mannol;
  • Dexamethasone;
  • Fraxiparin;
  • Femibion-2;
  • Wessel Douai F;
  • sometimes with APS, aspirin is prescribed to prevent thrombosis, as well as to prevent gestosis.

During pregnancy, there are certain indications for hospitalization of patients:

  • prenatal hospitalization in the obstetric and gynecological hospital for cerebral vein thrombosis;
  • there is varicose veins, in this case the patient is sent to a surgical hospital, the issue of maintaining or terminating the pregnancy is being decided;
  • patients are hospitalized in a neurosurgical hospital if an unspecified venous complication has occurred.

Thrombophilia – treatment with folk remedies

Folk experience has collected many recipes, some of which will be useful to reduce blood coagulation.

  • Tincture of Sophora Japanese. You need to take 100 grams of seeds and fill them with a half liter of good vodka. Insist for two weeks in a dark place. The drug is taken 3 times a day before meals, 10 drops of tincture are diluted in a quarter glass of water.
  • Grape juice is well established; its daily use reduces platelet activity.
  • Infusion of meadowsweet. 2 teaspoons must be filled with a glass of boiling water, strain and drink one third of a glass before meals.
  • It is useful to use infusions, preserves, stewed berries and raspberry leaves.
  • Garlic is one of the unique natural remedies that can thin the blood, so you can include 2-3 cloves in your diet.
  • Ginkgo biloba leaf extract is used.
  • Multicomponent infusion. A series of St. John’s wort for 20 grams; coriander fruits, licorice root naked, dried marshmallow, chamomile, flax, sweet clover 10 grams. A mixture of herbs is poured into 500 ml of boiling water and the extract is held for 2 hours. Then the infusion is filtered and drunk, you can add honey. The dosage is 200 ml twice a day, one hour after eating.

You can not use herbs that have a blood-clotting effect in case of a disease – water pepper, nettle. Before using folk remedies, you must always consult a doctor, many of them have contraindications.

After childbirth, administration of low molecular weight heparins continues for 2-6 weeks. During the first days after the birth, the previous doses continue to be administered if there were no obstetric complications in the birth (hypotonic bleeding, placental abruption, and others associated with blood loss). Further, heparin doses are regulated by a hematologist.

After the end of heparin therapy, the administration of antiplatelet agents (chimes, aspirins) or tablet anticoagulants (Wessel duet f) can be continued.

Folk remedies

During pregnancy, thrombophilia is also treated with traditional medicine, but it is better to use them not as the main therapy, but as concomitant methods.

  • Thrombophilia treatment with leeches. Their function of thinning the blood is very useful for people with a similar disease. They are used if vein blockage has already occurred and darkening of the skin at the site of damaged vessels has begun. They can not be kept for longer than five or ten minutes, depending on the severity, and also reused. All treatment takes an average of three to five days.
  • A very tasty way to defeat an ailment is to eat jam and drink compote made from raspberries. This berry has the same excellent property to prevent blood clotting. But overdoing with sweets is also not worth it. Remember to control your sugar intake.
  • The use of garlic also prevents the appearance of blood clots.

Thrombophilia Complications

Frozen pregnancy for short periods. This is due to a critical violation of blood flow in the vessels of the chorion. The resulting microthrombi clog vessels and severely disrupt the nutrition of the embryo, which leads to its death at an early stage.

All of the above conditions are due to manifestations of hypoxia (acute or decompensation of chronic fetal hypoxia). Constant insufficiency of the blood supply to the placenta leads to its cicatricial transformation, placental infarction and, ultimately, the formation of chronic placental insufficiency.

The formation of microthrombi in the vessels of the placenta also plays a role here. Usually in this case, the situation is complicated by hypertensive disorders in the mother (preeclampsia, gestational arterial hypertension, chronic arterial hypertension).

Thrombosis of various localizations. Most often, pregnant women have vein thrombosis of the lower extremities and pulmonary thromboembolism.

Vein thrombosis occurs more often in late pregnancy. Concerned about sharp pains in the affected limb (the lesion is first one-sided), swelling (the diameter of the limbs varies significantly), the limb may be reddened and hot to the touch. With deep vein thrombosis, the clinic is more erased, mainly it is pain in the limb. With thrombosis of superficial veins, the lesion area can be visually determined.

In case of thromboembolism of small branches of the pulmonary artery, the prognosis is more favorable, with a quick start of therapy, it is possible to stop the clinic and save the patient. With massive pulmonary embolism, mortality is very high, the prognosis is extremely unfavorable.

Other localizations of thrombosis are less common: ischemic stroke, central artery and / or central retinal vein thrombosis, heart attack, hepatic vein thrombosis, mesenteric thrombosis (vascular thrombosis of the mesentery of the small and / or large intestine).

Often during the treatment process, women experience side effects from taking the drugs. There is an increased formation of blood clots in the vessels. Particularly strong side effects are contraceptives, which in their composition will inhibit estrogen and heparin preparations.

In order to avoid side symptoms, doctors write a prescription for drugs that smooth out side effects. For example, acetylsalicylic acid has such properties. The specialist conducts regular monitoring of a woman’s coagulogram in order to avoid the development of early complications during pregnancy

Thrombophilia and pregnancy planning are far from mutually exclusive concepts. Many women often associate such a diagnosis with infertility, but this is not so. If you follow the entire treatment program, which individually will help to make a specialist, then giving birth to a healthy baby is quite realistic.

It is more likely that a woman who is sick with thrombophilia will give birth prematurely. But modern medicine works wonders and premature babies are not inferior in development to babies born on time. With the help of modern technology, premature babies quickly reach normal levels inherent in babies born after 9 months.

As you may have noticed, thrombophilia and pregnancy planning are compatible concepts if the expectant mother takes a responsible approach to pregnancy and believes only in the best.

Diseases, because her immunity is significantly reduced. Therefore, doctors always strongly recommend that future mothers should plan a pregnancy in the presence of chronic diseases in the body. This means a thorough medical examination and identification of possible problems in order to cure them, to prepare the body for bearing a child.

The main reason for the appearance of thrombophilia in a pregnant woman is a decrease in blood coagulation. This is due to the fact that the body of the expectant mother is preparing to reduce the risk of termination of pregnancy if there is any complication. The pregnant woman’s body thickens blood to reduce blood loss. And this can cause thrombosis. What can be thrombophilia from? The reasons may be:

  • dehydration;
  • damage to the integrity of blood vessels;
  • the presence of tumors;
  • genetic predisposition;
  • drug overdose;
  • deviations from the normal development of the fetus;
  • injuries congenital heart defects;
  • operations;
  • frequent and prolonged catheterization of veins;
  • infectious processes that are asymptomatic.

Another reason for the occurrence of thrombophilia in a pregnant woman can be the fact that a newly appeared third – placental – joins the two existing circles of blood circulation. During pregnancy, in the body of the expectant mother, blood acquires increased coagulability. Which reduces the risk of bleeding and blood loss.

The second half of pregnancy is considered a severe period. It is during this period that complications associated with the appearance of thrombophilia can occur:

  • miscarriage in late pregnancy;
  • stillbirth;
  • detachment of the placenta, which will be accompanied by heavy bleeding. This jeopardizes the life of both the mother and the fetus;
  • preterm delivery;
  • retardation in the development of the child, resulting from the formation of a blood clot in the vessels of the placenta;
  • impaired innervation of the placenta;
  • increased blood coagulation;
  • fetal hypoxia;
  • severe form of gestosis;
  • peritonitis;
  • myocardial infarction;
  • gangrene;
  • intestinal necrosis.

Prevention of Thrombophilia Complications

  • reconsider your lifestyle. Today, those who sit a lot and move a little are at risk of the disease. Moderate physical activity, exercise, physiotherapy exercises will only strengthen health;
  • proper diet, rejection of excessive consumption of fatty and smoked, as well as industrial semi-finished products;
  • reduce the amount of meat consumed;
  • special drinking regime – you must drink at least one and a half liters of clean water per day;
  • preventive medical examinations.

This article is posted for educational purposes only and is not scientific material or professional medical advice.

Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.

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