Assessment‐based management of placenta‐mediated pregnancy complications: pragmatism until a precision medicine approach evolves

Benjamin Brenner, Emmanouil Papadakis, Ian A. Greer, Jean‐Christophe Gris

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

The management of pregnant women with thrombophilia and a history of gestational vascular complications remains debatable. Treatment of the latter is often based on clinical outcome rather than disease mechanism. While the use of venous thromboembolism prophylaxis in pregnancy is recommended for those at increased risk, the ability of anticoagulant and/or antiplatelet agents to lower the risk of placenta-mediated complications in this clinical setting remains controversial. The available guidelines are inconsistent in some situations, which reflects the limited evidence base. This review critically discusses risk assessment models (RAMs) and management strategies of women with thrombophilia and pregnancy complications, using clinical vignettes. RAMs, taking into account obstetric and thrombotic history as well as thrombophilia status, could drive a precision medicine approach, based on disease mechanism, and guide individual therapeutic interventions in high-risk clinical settings.

Original languageEnglish
Pages (from-to)18-30
Number of pages13
JournalBritish Journal of Haematology
Volume202
Issue number1
Early online date11 May 2023
DOIs
Publication statusPublished - Jul 2023

Keywords

  • antithrombotics
  • placental diseases
  • pregnancy
  • risk assessment methods
  • thrombophilia

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