Hamostaseologie 2020; 40(03): 356-363
DOI: 10.1055/a-1184-8388
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Understanding and Preventing Placenta-Mediated Pregnancy Complications

Leslie Skeith
1  Division of Hematology and Hematological Malignancies, Department of Medicine, University of Calgary, Calgary, Canada
,
Marc Blondon
2  Division of Angiology and Hemostasis, Department of Specialties of Medicine, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
,
Fionnuala Ní Áinle
3  Department of Haematology, School of Medicine, University College Dublin, Rotunda Hospital and Mater University Hospital, Irish Network for VTE Research (INViTE), Dublin, Ireland
› Author Affiliations
Further Information

Publication History

02 February 2020

21 May 2020

Publication Date:
29 July 2020 (online)

Abstract

Placenta-mediated pregnancy complications are clinically important conditions and include preeclampsia, placental abruption, intrauterine growth restriction, and late fetal loss. Pathophysiology is complex, and may be linked to prothrombotic disorders such as antiphospholipid syndrome, whose understanding is still evolving. In this narrative review, we will present the latest evidence to better understand hemostatic mechanisms of preeclampsia, as well as in women with placenta-mediated pregnancy complications and inherited thrombophilia or antiphospholipid antibodies. Using four clinical scenarios, the mixed results of preventive efforts through the use of antithrombotic drugs (aspirin, heparin) will be discussed. We will also review knowledge gaps and ongoing research.

Authorship

All authors (L.S., M.B., F.N.A.) contributed to writing the first and subsequent drafts of the manuscript.