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By Katherine A. High

This exact, single-source reference presents accomplished insurance of the molecular biology and genetics of the criteria serious about blood clotting and fibrinolytic structures in addition to the antiproteases that regulate these reactions.

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Even when the birth weight centile was reduced to the 5th centile and the analysis repeated, there was no relationship, suggesting that, in contrast to pre-eclampsia, there is no relationship to disease severity. 2). Thus, the lack of association between IUGR and MTHFR C677T homozygotes may reflect the widespread use of multivitamin preparations containing folic acid in pregnancy, which could influence homocysteine levels, and emphasizes the need for consideration of plasma 34 VENOUS THROMBOSIS IN WOMEN homocysteine rather than the MTHFR genotype alone.

Other mechanical techniques such as intermittent pneumatic compression are of value during Cesarean section and immediately postpartum for prophylaxis. Aspirin has been found in meta-analysis to have a beneficial effect in the prevention of DVT. Its effectiveness for VTE prophylaxis in pregnancy, in comparison with heparin, remains to be established, but it is likely to offer some benefit. Its effectiveness is likely to be less than that of heparin and LMWH133. In women who are unable to take heparin or in whom the balance of risk is not considered sufficient to merit heparin, it may be useful.

Thrombophilia screening is of limited value in women with acute VTE. 6). A laboratory assessment (ideally prior to anticoagulant therapy) can be considered, although it is ideal to delay full laboratory screening until 1 month after anticoagulation has been discontinued. The results of a thrombophilia screen will not usually influence the diagnosis or the immediate management of acute VTE; however, it may influence the duration and intensity of anticoagulation, such as when antithrombin deficiency is identified in pregnancy.

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