In an attempt to reduce the incidence of pregnancy associated venous thromboembolism (PA-VTE), some researchers have advocated screening of all women for the factor VLeiden mutation during early pregnancy.
We have conducted a large retrospective study (over 72,000 deliveries) to determine if this would be useful.
Sixty-two objectively confirmed venous thrombotic events (51 DVT, 11 PE) were recorded at two maternity units in the UK.
The incidence of DVT was 0.71 per 1000 deliveries (95% CI 0.5-0.9) with 0.50 occurring in the antenatal period (95% CI 0.34-0.66) and 0.21 in the puerperium (95% CI 0.11-0.31).
The incidence of PE was 0.15 per 1000 deliveries (95% CI 0.06-0.24), 0.07 antenatal (95% CI 0.01-0.13) and 0.08 in the puerperium (95% CI 0.02-0.14).
Of these 62,50 attended for follow-up and thrombophilia screening. 28% of all episodes of PA-VTE had no clinical risk factor for thrombosis or an identifiable thrombophilic abnormality.
Deficiency of antithrombin was identified in 12% of individuals (95% CI 3-21) and the factor VLeiden mutation in 8% (95% CI 0.5-15.5).
Based on estimates of the prevalence of the factor VLeiden mutation in the population, we estimate that the thrombotic risk for a woman during pregnancy or the puerperium with the defect is approximately I in 400-500.
This figure would not lend support to the idea of random screening for the mutation in early pregnancy.
Mots-clés Pascal : Thrombose, Veine, Thromboembolie, Facteur risque, Gestation, Postpartum, Epidémiologie, Ecosse, Grande Bretagne, Royaume Uni, Europe, Homme, Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Veine pathologie, Facteur V Leiden
Mots-clés Pascal anglais : Thrombosis, Vein, Thromboembolism, Risk factor, Pregnancy, Puerperium, Epidemiology, Scotland, Great Britain, United Kingdom, Europe, Human, Cardiovascular disease, Vascular disease, Venous disease, Factor V Leiden
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0493029
Code Inist : 002B20F01. Création : 03/02/1998.