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

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2 Answers
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Mednet MemberInvited Expert
Hematology · Gundersen Health
Answered on

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...

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Mednet Member
Mednet Member
Medical Oncology · Main Line Health
Answered on

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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