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Venous thromboembolism (VTE) is a common cause of morbidity and mortality and has been implicated in the pathophysiology of a number of obstetric complications. This chapter provides an overview of the more common genetic thrombophilias and the acquired thrombophilia associated with the presence of antiphospholipid antibodies. A limited number of genetic variants are proven to be independent risk factors for VTE. These include mutations in the genes controlling the function of both pro- and anticoagulant factors. The main benefit in screening thrombophilia is to prevent a first VTE in affected relatives rather than secondary prevention of recurrent VTE. Oral contraceptives increase the risk of VTE, particularly in the first year of use. Women with thrombophilic defects are at greater risk. Improved pregnancy outcomes in women with antiphospholipid syndrome can be achieved with the use of aspirin and low-dose heparin.
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