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Mathematical and biological models of blood coagulation. A rebuttal
Author(s) -
HEMKER H. C.,
DE SMEDT E.,
HEMKER P. W.
Publication year - 2006
Publication title -
journal of thrombosis and haemostasis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.947
H-Index - 178
eISSN - 1538-7836
pISSN - 1538-7933
DOI - 10.1111/j.1538-7836.2005.01783.x
Subject(s) - rebuttal , coagulation , medicine , computational biology , biology , political science , law
invaded the walls of the interdecidual portions of the uterine spiral arteries and normally this process is complete by 20–22 weeks’ gestation (failure of the process to occur normally may be a factor in the development of gestational hypertension) [2]. Thus, it appears clear that this process is a ‘continuum’ and it is difficult, from a biological point of view, to understand why the risk increases starting from the 10th week. Although we strongly believe that the inherited thrombophilia must play a role in well-selected settings of women, nevertheless, we would remember that thrombophilia confers a susceptibility to miscarriage and that the probability to carry out an uneventful pregnancy with one previous fetal loss according to epidemiological data by Stirrat [4] is still about 78–86%; even after three ormore consecutive losses, the chance of a successful pregnancy is still at best 75% and at worst 54%. This information should allow all obstetricians to draw a practical implication: why should we test for thrombophilia a woman after the first fetal loss and eventually to treat those with a positive result in the following pregnancies, without the certainty (or the high probability) that thrombophilia is playing a role in miscarriage in that woman?