Diagnostik und Therapie der Venenthrombose in der Schwangerschaft

Hach-Wunderle,; Präve, F.; Düx, M.; Hoffmann, Alana; Zegelman, M.; Hach, W.

doi:10.1055/s-2008-1046744

Cited by 5 publications

(6 citation statements)

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“…nach durchgemachter Thrombose, ist eine medikamentöse Prophylaxe mit niedermolekularem Heparin, das nicht plazentagängig ist, sinnvoll. Genaue Richtlinien gibt es jedoch nicht [6].…”

Section: Geringerer Sauerstoffgehalt In Der Höheunclassified

Schwangerschaft und Reisen

Walentiny

2009

Dtsch med Wochenschr

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The second trimester is the safest time for travelling, because the pregnant woman feels generally most at ease and the risk of spontaneous abortion and pre-term labour is very low. Possible risks must be discussed with the obstetrician before travelling. If the pregnancy is uncomplicated most airlines allow flying up to the 36th (domestic flights) and 35th (international flights) week of gestation. Unless the fetal oxygen supply is already impaired at ground level due to an underlying disease, flying does not pose a risk of fetal hypoxia. Radiation exposure during a long distant flight is low compared to the average annual exposure dosage, but the risk of thrombosis is increased. Altitudes up to 2,500 m pose no problem. Sufficient time to acclimatize must be taken when travelling to high altitudes and exercise kept to a minimum. Scuba diving is contraindicated. Since only a few drugs are completely safe during pregnancy a thorough risk/benefit evaluation is mandatory. Treatment of infections can be considerably complicated, but any necessary treatment should not be withheld because of the fear of potential fetal injury. Good knowledge of local medical resources is essential before travelling. Several personal protective measures minimize the risk of infection: food and water precautions, protection from insect bites and avoidance of crowds, unsafe sex and, if need be, freshwater. Many vaccinations are recommended for travellers. However, live vaccines are contraindicated in pregnant women because of theoretical considerations. Exceptionally a yellow fever vaccination may be given after the first trimester. Killed, inactivated or polysaccharide vaccines can be given after the first trimester after a thorough risk/benefit evaluation. Because of the potentially devastating effect of malaria to the mother and the child, travelling to endemic malaria regions should be avoided. If the risk of infection is high chemoprophylaxis with mefloquine is indicated. In low-risk countries mefloquine, in South-East-Asia artemisinin derivatives should be given as stand-by treatment.

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“…nach durchgemachter Thrombose, ist eine medikamentöse Prophylaxe mit niedermolekularem Heparin, das nicht plazentagängig ist, sinnvoll. Genaue Richtlinien gibt es jedoch nicht [6].…”

Section: Geringerer Sauerstoffgehalt In Der Höheunclassified

Schwangerschaft und Reisen

Walentiny

2009

Dtsch med Wochenschr

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“…Ein besonderes Risiko einer Thrombose stellt auch das Wochenbett dar, sodass eine Thromboseprophylaxe unbedingt auch diesen Zeitraum mit umfassen muss. Für die Behandlung in der Schwangerschaft bietet sich niedermolekulares Heparin an, das nicht plazentagängig ist [8]. Etwa …”

Section: Blutgefäßeunclassified

What does the obstetrician expect from the internist during prenatal care?

Schneider

2008

Internist

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Cooperation between the obstetrician and the physician for internal medicine is especially needed when a pregnant woman suffers from complex medical diseases. This contribution focuses on the special circumstances of maternal treatment also considering the fetal state with the following examples: drugs in the first trimester, cardiac diseases, pregnancy-induced hypertension, HELLP syndrome, gestational and type I diabetes, thrombosis, pulmonary diseases, infections, and treatment of cancer during pregnancy. Special obstetric requests to the physician are: keeping in close contact, avoiding recommendations for the mode of delivery, avoiding overtreatment of hypertensive disorders as well as intensifying the surveillance including the creation of preventive schedules for pregnant women with an increased risk of developing metabolic syndrome in their later life.

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“…Perinatal venous thromboembolism (VT) is the leading cause of maternal death in developed countries [1][2][3]. The increase in gestational weeks increases the risk of VT [4,5], and the peak period of VT occurs within 6 weeks after delivery [6]. However, the pathogenesis of VT is not clear.…”

Section: Introductionmentioning

confidence: 99%

“…VT is a disease caused by multiple factors [7][8][9], which may be related to specific gene expression [10,11]. In addition, pregnancy itself is a high-risk factor for VT [3][4][5]12]. Changes in estrogen and progesterone levels during pregnancy lead to vasodilatation of lower limb veins [3,5].…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of Low Molecular Weight Heparin in Preventing Perinatal Venous Thrombosis: A Meta-Analysis

Huang¹,

Li²,

Li³

et al. 2022

Computational and Mathematical Methods in Medicine

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Background. There have been controversies about the preventive effect of low molecular weight heparin (LMWH) on venous thrombosis (VT) in the perinatal period. This study is aimed at exploring the effectiveness of LMWH in preventing perinatal VT through meta-analysis. Methods. Databases such as CNKI, China Biology Medicine disc (CBMdisc), Wanfang, PubMed, MEDLINE, Embase, and Central were searched. Inclusion criteria were as follows: (1) subjects: women at high risk of perinatal VT; (2) experimental group and control group; (3) intervention measures: the experimental group was given LMWH, while the control group was given placebo or standard heparin or physical therapy; (4) outcomes: perinatal VT events or bleeding events; and (5) randomized controlled trials (RCTs). Jadad scale was used to evaluate the literature quality. The Mantel-Haenszel method was used to calculate the odds ratio (OR) and 95% confidence interval (CI). The chi-square test was used to analyze the heterogeneity of the included literature. Subgroup analysis was used to explore the source of heterogeneity. Publication bias was evaluated via funnel plot and Egger test. Results. The incidence of perinatal VT in the LMWH group was lower than that in the control group ( OR = 0.16 , 95% CI (0.08, 0.32), P < 0.00001 ). There was no heterogeneity among literatures ( P = 0.77 , I 2 = 0 % ) and no publication bias. The incidence of postpartum VT in the LMWH group was lower than that in the control group ( OR = 0.14 , 95% CI (0.07, 0.30), P < 0.00001 ). There was no heterogeneity among literatures ( P = 0.69 , I 2 = 0 % ) and no publication bias. The incidence of perinatal bleeding in the LMWH group was higher than in the control group ( OR = 1.72 , 95% CI (1.06, 2.77), P = 0.03 ). There was no heterogeneity among literatures ( P = 0.25 , I 2 = 26 % ) and no publication bias. Conclusion. LMWH can reduce the incidence of perinatal VT in high-risk women but increase the risk of bleeding. The use of LMWH to prevent perinatal VT should be closely monitored.

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Diagnostik und Therapie der Venenthrombose in der Schwangerschaft

Cited by 5 publications

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Schwangerschaft und Reisen

Schwangerschaft und Reisen

What does the obstetrician expect from the internist during prenatal care?

Efficacy of Low Molecular Weight Heparin in Preventing Perinatal Venous Thrombosis: A Meta-Analysis

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