Retinal artery and vein thrombotic occlusion during pregnancy: markers for familial thrombophilia and adverse … – Dove Medical Press

Will S Kurtz,¹ Charles J Glueck,¹ Robert K Hutchins,^2,3 Robert A Sisk,^2,3 Ping Wang¹

¹Cholesterol, Metabolism, and Thrombosis Center, Jewish Hospital of Cincinnati, ²Cincinnati Eye Institute, ³Department of Ophthalmology, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA

Background: Ocular vascular occlusion (OVO), initial diagnosed throughout or right away after giving birth, frequently reflects superposition of the physiologic thrombophilia of pregnancy regard previously undiagnosed underlying familial or acquired thrombophilia associated along with spontaneous abortion, eclampsia, or maternal thrombosis.
Specific aim: We describe OVO, initial diagnosed throughout pregnancy or right away postpartum, in 3 young females (ages 32, 35, 40) associated along with previously undiagnosed familial thrombophilia.
Results: Branch retinal artery occlusion (BRAO) taken place at 9 and 13 weeks gestation in 2 females, aged 32 and 35. Central retinal vein occlusion taken place right away postpartum in a 40-year-old. Among the 2 females along with BRAO subsequently produced eclampsia, and one owned a history of unexplained initial trimester spontaneous abortion. All of 3 females were discovered to have actually previously unexplained familial thrombophilia. the 2 females along with BRAO owned reasonable initial trimester free healthy protein S 42 (41%), lesser regular restriction (50%), and Among these 2 owned higher reason VIII (165%, top regular restriction 150%). The woman along with central retinal vein occlusion owned higher reason XI (169%, top regular restriction 150%). Enoxaparin (40–60 mg/day) was started and continued throughout pregnancy in the 2 females along with BRAO to avoid maternal–placental thrombosis, and of these 2 females, one owned an uncomplicated pregnancy path and term delivery, and the 2nd was at gestational week 22 devoid of complications at the moment of this manuscript. There were no further OVO events in the 2 females treated along with enoxaparin or in the untreated patient along with postpartum eclampsia.
Conclusion: OVO throughout pregnancy could be a marker for familial or acquired thrombophilia, which confers increased thrombotic threat to the mother and pregnancy, associated along with spontaneous abortion or eclampsia. OVO throughout pregnancy, particularly as soon as coupled along with antecedent edge pregnancy outcomes, must prompt urgent thrombophilia evaluation and institution of thromboprophylaxis to avoid edge maternal and fetal–placental thrombotic events.

Keywords: thrombophilia, ocular thrombosis, retinal vascular occlusion, CRVO, BRAO, pregnancy, miscarriage, fetal loss, ocular vascular occlusion, pre-eclampsia, eclampsia

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