Would you consider thrombophilia testing in a pregnant patient with VTE?

If work-up is sent and the patient is found to have a persistently positive antiphospholipid antibody, particularly lupus anticoagulant, would you consider life long anticoagulation with warfarin or attribute the thrombus to pregnancy?

Answer from: at Community Practice

I would not check antiphospholipid antibodies in a pregnant woman with thrombosis unless she had a history of autoimmune disease or other concerning findings. However, if it were checked, I would make sure that it is a true positive. DOACs often cause a false positive LAC. I have had patients with f...

Comments

at Indiana Hemophilia and Thrombosis Center
Thank you Dr. @Rosenstein. As it turns out, our p...

at UTMB Health
I agree. I would check for antiphospholipid antibo...

at Indiana Hemophilia and Thrombosis Center
Thank you Dr. @Gonzalez. Our patient did not have...

Answer from: Medical Oncologist at Community Practice

I would request lupus anticoagulant and anticardiolipin antibody and if positive, repeat in 8-12 weeks and that will impact what to do after delivery. She will be on Lovenox during pregnancy, but she is at risk after and would need to know what to give, Warfarin vs DOACs.

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Would you consider thrombophilia testing in a pregnant patient with VTE?

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