Abstract
ABSTRACTObjective To standardize the investigation and clinical management of women with laboratory and/or clinical abnormalities suggestive of thrombophilia, in order to optimize antithrombotic approach and indication of laboratory tests.Methodology A discussion was carried out among 107 physicians (gynecologists/obstetricians, hematologists and vascular surgeons) present at a forum held at the Hospital Israelita Albert Einstein, in São Paulo (SP), Brazil. As a minimum criterion, 80% agreement was established in the voting to each recommendation of conduct in the final document. The cases in which there was agreement below 80% were discussed again, reaching a consensual agreement of conduct for the document writing.Conclusion The standardization of an institutional consensus of suggestions of clinical approach contributes to a better management of the group to be evaluated and minimizes risks of intercurrent events. This was the first national consensus on the investigation of thrombophilia in women.
Highlights
Thrombophilia is defined as a tendency towards thrombosis resulting from hereditary alterations (deficiency of proteins C, S and antithrombin; factor einstein (São Paulo). 2019;17(3):1-7Nascimento CM, Machado AM, Guerra JC, Zlotnik E, Campêlo DH, Kauffman P, Waksman H, Wolosker N, Podgaec S, Hamerschlak NV Leiden − FVL − mutation; and protrombin gene mutation) or acquired from coagulation that lead to a state of pro-thrombosis, which predisposes people to present with venous or arterial thrombosis
The hematology team of Hospital Israelita Albert Einstein (HIAE) performed a search, in April 2017, of scientific articles published in PubMed®/MEDLINE® between January 2007 and January 2017, inserting the words in English: “thrombophilia”, “thrombosis and pregnancy”, “thrombophilia and screening”, “pre-hormone therapy”
The retrieved articles were analyzed as to their relevance, scope, and study design, which generated a list of randomized clinical studies, meta-analyses, systematic reviews, and guidelines,(1,6-11) which was forwarded as a suggestion of reading via e-mail to the medical staff of the 539 specialist physicians registered in hematology, vascular surgery, einstein (São Paulo). 2019;17(3)
Summary
To standardize the investigation and clinical management of women with laboratory and/or clinical abnormalities suggestive of thrombophilia, in order to optimize antithrombotic approach and indication of laboratory tests. Conclusion: The standardization of an institutional consensus of suggestions of clinical approach contributes to a better management of the group to be evaluated and minimizes risks of intercurrent events This was the first national consensus on the investigation of thrombophilia in women. Pregnancy is associated with physiological changes that affect coagulation and the fibrinolytic system An imbalance in this system leads to a state of hypercoagulability, and pregnant women have, an increased risk of venous thromboembolism (VTE) events.[2] The incidence of thromboembolism in pregnant women is 0.6 to 1.7 case in 1,000 gestations.[3]. Literature recommends that the laboratory investigation of thrombophilia be guided by the history of the patient, family history of thrombosis, and suggested when its result will partially affect the clinical management. Cost-effectiveness studies have shown that the indiscriminate use of thrombophilia tests in the general population were not effective in preventing deaths or other events.[9,10,11]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
