Pregnancy outcome after a first episode of cerebral vein thrombosis: reply

Abstract

Background The risk of recurrent thrombosis and bleeding episodes in women with previous cerebral vein thrombosis (CVT) on antithrombotic prophylaxis with low-molecular weight heparin (LMWH) during pregnancy is not established and little information is available on pregnancy outcome. Objectives Aims of this study were to evaluate the risk of obstetrical complications, recurrent venous thrombosis and bleeding and in a cohort of pregnant women on LMWH after a first episode of CVT. In addition, to estimate the relative risk of obstetrical complications, patients were compared to healthy women without thrombosis and with at least one pregnancy in their life. Patients We studied a cohort of 52 patients and 204 healthy women. Results The risk to develop late obstetrical complications was 24% (95% CI 18%-38%), leading to a relative risk of 6.09 (95% CI 2.46-15.05). The risk of miscarriage was not increased. The higher risk of late obstetrical complications in patients appeared unrelated to a previous history of obstetrical complications, to the carriership of thrombophilia abnormalities, or to the presence of comorbidities. A double prevalence of termination was observed in patients with thrombophilia than in those without. No recurrent thrombosis nor bleeding episodes was observed. Conclusions Women with previous CVT on LMWH prophylaxis during pregnancy have a low risk to develop recurrent thrombosis or bleeding episodes, but seems to have an increased risk of late obstetrical complications. This article is protected by copyright. All rights reserved.