During pregnancy for patients with Factor V Leiden, management may include...

During pregnancy for patients with Factor V Leiden, management may include...

• A. Indefinite anticoagulation during pregnancy
• B. Thromboprophylaxis during pregnancy to prevent miscarriages
• C. No prophylaxis during pregnancy
• D. Aspirin during pregnancy only

Answer: (B)

Factor V Leiden causes resistance to activated protein C, heightening the tendency to form clots. Pregnancy already shifts toward a procoagulant state, with increased clotting factors and venous stasis from the enlarging uterus. In combination, this raises the risk of thrombosis in the placental circulation, which can contribute to pregnancy loss and placental insufficiency. To mitigate these risks, thromboprophylaxis during pregnancy—usually with low molecular weight heparin—is used to reduce clot formation in the placenta and prevent thrombotic complications, while avoiding fetal exposure to teratogenic agents. Aspirin alone does not adequately address the hypercoagulable state in Factor V Leiden, and indefinite anticoagulation or no prophylaxis do not appropriately balance risks and benefits in this context.

Factor V Leiden causes resistance to activated protein C, heightening the tendency to form clots. Pregnancy already shifts toward a procoagulant state, with increased clotting factors and venous stasis from the enlarging uterus. In combination, this raises the risk of thrombosis in the placental circulation, which can contribute to pregnancy loss and placental insufficiency. To mitigate these risks, thromboprophylaxis during pregnancy—usually with low molecular weight heparin—is used to reduce clot formation in the placenta and prevent thrombotic complications, while avoiding fetal exposure to teratogenic agents. Aspirin alone does not adequately address the hypercoagulable state in Factor V Leiden, and indefinite anticoagulation or no prophylaxis do not appropriately balance risks and benefits in this context.