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Testing for Genetic Disorders

Related Genetic Tests

Blood Clotting Disorders

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RECURRENT PREGNANCY LOSS

Women and Thrombophilia

At different times in their lives, women may face a number of unique factors or events that can affect their risk for developing a blood clot (venous thrombosis). These include birth control pills, hormone replacement therapy, and pregnancy, in addition to certain lifestyle factors.

If a women also has a blood clotting disorder, her risks during these times can be much higher. Thrombophilia can also contribute to miscarriages and complications during pregnancy.

Birth Control Pills
Hormone Replacement Therapy
Pregnancy
Complications With Pregnancy

Birth Control Pills

All women who use birth control pills have an increased risk of developing a potentially dangerous blood clot, compared with women who do not take the Pill.

If you have an inherited blood clotting disorder, such as factor V Leiden or a prothrombin mutation, you have an even greater risk (at least 35 times higher) for developing a blood clot in the veins when using certain types of birth control pills, especially during the first year of use.

If you are significantly overweight (BMI of 30 or more), your risks for a clot are also higher.

Risk Factor	Risk of Blood Clot
Not taking oral contraceptives (OC)	1 in 12,500
Taking OC	1 in 3,500
Taking OC with factor V Leiden (one copy)	1 in 500
Taking OC with prothrombin (one copy)	1 in 800
Taking OC with factor V Leiden (two copies)	1 in 150
Taking OC with prothrombin (two copies)	unknown
Taking OC and being obese (BMI 30 or more)	1 in 100

Hormone Replacement Therapy

All women who use HRT have an increased risk of developing a blood clot in the veins, especially during the first year of treatment. But if you have an inherited blood clotting disorder — factor V Leiden or a prothrombin mutation — your risk can be 13 to 15 times greater, or more, than a woman without the disorder.

Risk Factors	Risk of a Blood Clot
Not taking HRT	1 in 1000
Taking HRT	2 to 4 in 1000
Taking HRT and having factor V Leiden	15 in 1000

If you have used HRT in the past but are not currently taking it, your risk is no longer increased.

Pregnancy

All women who are pregnant have a greater chance of developing a potentially dangerous blood clot. For women with either or both of the two most common inherited blood clotting disorders — factor V Leiden or a prothrombin mutation — the chance of having a pregnancy-related blood clot is at least 10 times higher.

These women also have an increased risk for other pregnancy-related complications, which include preeclampsia, placental abruption, and poor fetal growth.

Risk Factor	Risk of Blood Clot
All women (under 40 years)	1 in 10,000
Pregnant women	1 in 1000
Pregnant with factor V Leiden (one copy)	1 in 100
Pregnant with prothrombin (one copy)	1 in 500
Pregnant with factor V Leiden (two copies)	1 in 25

Complications With Pregnancy

About 10 to 15 percent of all women who have experienced multiple miscarriages have one or more inherited thrombophilias. Factor V Leiden carries a slightly greater risk for miscarriage than the prothrombin mutation.

Risk Factor	Chance of Miscarriage
Average	1 to 3%
Factor V Leiden	up to 30%
Prothrombin mutation (one copy)	4 to 9%

An inherited blood clotting disorder may be at the root of some women's pregnancy-related complications, as well. Many women who have experienced the following complications have an inherited blood clotting disorder.

Preeclampsia — extremely elevated blood pressure and protein in the urine.
Placental abruption — a situation in which the placenta tears away from the side of the uterus, often resulting in heavy bleeding.
Intrauterine growth restriction (IUGR) — when a baby is considerably smaller than expected, which may impact the health of the baby.

It is believed that the blood's greater tendency to clot increases the risk of a blood clot that may interfere with fetal growth.