How is thrombosis prevented in patients with protein S deficiency?

Updated: Jan 03, 2021
  • Author: Mohammad Muhsin Chisti, MD, FACP; Chief Editor: Perumal Thiagarajan, MD  more...
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Answer

In patients who are asymptomatic carriers of protein S deficiency, the goal of therapy is prevention of the first thrombosis. In such patients, avoid drugs that predispose to thrombosis, including oral contraceptives. In these patients, if surgery is performed or orthopedic injury occurs, prophylaxis with heparin is mandatory.

Protein S deficiency is considered a high-risk thrombophilia during pregnancy, with absolute risks of pregnancy-associated VTE being 0.9% antepartum and 4.2% postpartum. [41] Experts recommend prophylaxis with LMWH. The timing is controversial, but most experts would treat from the second trimester through 4-6 weeks postpartum.

The patient's bleeding risks must be assessed on an individual basis for any of these prophylactic recommendations. No single prescription fits all cases.


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