How we manage venous thromboembolism during pregnancy

Bates, Shannon M.; Ginsberg, Jeffrey S.

doi:10.1182/blood-2002-03-0965

Cited by 111 publications

(68 citation statements)

References 91 publications

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“…8 Thus, treatment onset should be as early as possible. LMWH and conventional heparin do not cross placental barrier, opposed to warfarin, which has risk of fetal malformation, especially between the sixth and 12th gestational week, besides providing more hemorrhagic complications.…”

Section: Discussionmentioning

confidence: 99%

Investigação da trombose venosa na gravidez

Kalil¹,

Jovino²,

Lima³

et al. 2008

J. vasc. bras.

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Background: Deep venous thrombosis (DVT) during pregnancy is a determining factor that contributes to increased maternal-fetal morbidity and mortality. It may occur when there is thrombophilia, due to compression of the inferior vena cava, venous stasis or hormonal changes. Objectives: To assess patients who are pregnant or have just given birth and who have a DVT condition in the lower limbs, to search for possible causes of thrombophilia and to perform a review of the literature. Methods: Pregnant and puerperal patients were assessed by gynecologists and obstetricians when there was suspicion of DVT, from January 2004 through November 2006, during which time there were 24,437 childbirths at Hospital e Maternidade São Luiz; of these, 89% were cesarean, 7.5% were normal births and 3.5% were forceps deliveries. Of the total number of patients referred with a clinical status suggesting DVT, 42 cases were clinically diagnosed as DVT, in pregnant women aged between 21-39 years, confirmed by venous duplex scan. Right before the introduction of anticoagulant therapy, samples were collected to investigate thrombophilia, which were repeated after the treatment. Results: Of the 42 patients with DVT, 32 were primigravid (three twin pregnancies with no thrombophilic changes, two resulting from in vitro fecundation), eight were mothers at second birth and two were at third birth. In four patients, DVT occurred in the first trimester of pregnancy (9.5%), in 11 patients DVT was present in the second trimester (26.2%) and in 27 patients the disease developed in the third trimester of pregnancy (64.3%). Of the 42 patients diagnosed with DVT, 18 (42.8%) occurred in infrapatellar veins. There was a case of pulmonary thromboembolism in a 37-year-old patient, who had been submitted to in vitro fecundation, with twin pregnancy and a

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Section: Discussionmentioning

confidence: 99%

Investigação da trombose venosa na gravidez

Kalil¹,

Jovino²,

Lima³

et al. 2008

J. vasc. bras.

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“…É fundamental estabelecer um diagnóstico objetivo por meio de exames de imagem. A utilização de exames diagnósticos que produzem radiação, com as precauções adequadas, fazem com que a quantidade absorvida pelo feto e seu consequente risco sejam mínimos 10 .…”

Section: -Diagnóstico Da Tevunclassified

“…No entanto, se tais sintomas ocorrerem no primeiro trimestre, particularmente na perna esquerda, a presença de TVP é mais provável 10 . Dor em abdome inferior pode ser devido à circulação colateral ou à trombose periovariana 3 .…”

Section: -Diagnóstico Da Tvpunclassified

“…O exame não invasivo recomendado inicialmente é o US por compressão, que deve ser em todo o sistema venoso proximal 10 . Se a suspeita clínica é alta, mas os testes não invasivos são negativos para TVP, a venografia limitada com proteção abdominal que resulta em exposição feral < 0,05 rads deve ser considerada 11 .…”

Section: Os Testes Diagnósticos Podem Ser Não Invasivos (Ultrassom [Uunclassified

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15. Tromboembolismo venoso agudo

Gazzana¹,

Tedoldi²,

Barreto³

2009

Arq. Bras. Cardiol.

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“…Therefore, recommendations for the diagnosis of DVT or PE during pregnancy are largely empirical and based on extrapolations from studies performed in nonpregnant patients. [16][17][18] Venous ultrasound Ultrasound of the entire proximal venous system is the initial test for suspected DVT during pregnancy (Figure 1). Ultrasound is known to have a high diagnostic accuracy in non-pregnant populations; 19 consequently, if the initial test shows a clear-cut abnormality in the popliteal or femoral veins, a diagnosis of proximal DVT is made.…”

Section: Epidemiology Of Vte During Pregnancymentioning

confidence: 99%

Management of venous thrombosis in pregnancy

Nelson

Greer

2008

Trends Urology, Gynecol. Sexual Health

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The management of venous thromboembolism in pregnancy is challenging, as many diagnostic tests are less accurate in pregnant than in non‐pregnant patients, and some of the radiological procedures are potentially hazardous to the fetus. In addition, anticoagulant treatment with coumarins can cause embryopathy. The authors recommend strategies for women at risk of deep venous thrombosis or pulmonary thromboembolism during pregnancy and outline appropriate investigations and treatment. Copyright © 2008 Wiley Interface Ltd

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How we manage venous thromboembolism during pregnancy

Cited by 111 publications

References 91 publications

Investigação da trombose venosa na gravidez

Investigação da trombose venosa na gravidez

15. Tromboembolismo venoso agudo

Management of venous thrombosis in pregnancy

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