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Five mutations to watch for: VTE risk and thrombogenic mutations in pregnancy.(Obstetrics)
LAS VEGAS -- There are six key thrombogenic mutations to be concerned about in pregnant patients, Dr. Charles Lock-wood said at the Fifth World Congress on Controversies in Obstetrics, Gynecology, and Infertility.
These include:
* Factor V Leiden mutation. About 80% of women with activated C-reactive protein resistance have this mutation. Both men and women with factor V Leiden mutation face a 30% lifetime risk of venous thromboembolism (VTE), and the prevalence in Europeans ranges from 5% to 15%. The prevalence of the mutation in the United States is about 5%, said Dr. Lockwood, who chairs the department of obstetrics, gynecology, and reproductive sciences at Yale University, New Haven.
About 40% of VTE events in pregnancy are caused by factor V Leiden mutation. Women with the mutation face a 10-fold increased risk of VTE during pregnancy.
However, this risk remains low in asymptomatic heterozygotes, at 0.2%, whereas the risk is far higher in homozygotes, at 16%-17%.
* Prothrombin gene mutation. Patients with this mutation also face a 30% lifetime risk of VTE; the prevalence is 2%-3%.
About 17% of VTE events in pregnancy are caused by the prothrombin gene mutation, and those who have it face a 15-fold increased risk of VTE during pregnancy. The risk of VTE in heterozygotes is just 0.5%, but the risk in homozygotes is 15%.
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