Pulmonary Thromboembolism in Obstetrics and Gynecology Increased by 6.5-Fold Over the Past Decade in Japan

Kobayashi, Takao; Nakabayashi, Masao; Ishikawa, Mutsuo; Adachi, Tomoko; Kobashi, Gén; Maeda, Makoto; Ikenoue, Tsuyomu

doi:10.1253/circj.72.753

Cited by 42 publications

(43 citation statements)

References 20 publications

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“…The incidence of PTE after C/S is 0.06% and that of DVT after C/S is 0.04% among the general population in Japan. After C/S, women are estimated to have 22-and five-times higher risks of PTE and DVT, respectively, than those after transvaginal delivery [2]. The rate of C/S has been increasing steadily over the past decades in developed countries, including Japan [2].…”

Section: Introductionmentioning

confidence: 99%

“…After C/S, women are estimated to have 22-and five-times higher risks of PTE and DVT, respectively, than those after transvaginal delivery [2]. The rate of C/S has been increasing steadily over the past decades in developed countries, including Japan [2]. Consequently, prevention of venous thromboembolism (VTE) after C/S has become a pivotal part of current obstetric practice that aims to further reduce the incidence of maternal pregnancy-related death.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Safety and efficacy of thromboprophylaxis using enoxaparin sodium after cesarean section: A multi-center study in Japan

Goto

Yoshizato

Tatsumura

et al. 2015

Taiwanese Journal of Obstetrics and Gynecology

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of thromboprophylaxis using enoxaparin sodium after cesarean section: A multi-center study in Japan

Goto

Yoshizato

Tatsumura

et al. 2015

Taiwanese Journal of Obstetrics and Gynecology

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“…Asian pregnant women have a significant lower risk of venous thromboembolism compared to white pregnant women (1.07 vs 1.75/1000 deliveries) [3]. Pulmonary thromboembolism in pregnant Japanese population is comparatively rare; but in last decade incidence increased by 6.5 folds [4]. No literature is available about peripartum pulmonary embolism in India but overall incidence of pulmonary embolism is lower in Indian population [5].…”

Section: Introductionmentioning

confidence: 99%

Peripartum pulmonary embolism: Anesthetic and surgical considerations

Shaikh¹,

Ummunnisa²,

Aboobacker³

et al. 2013

OJOG

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Pregnancy and peripartum period leads to Virchow's triad (hypercoagulability, venous stasis and vascular injury) thereby increasing the risk of thromboembolism by many folds in these patients. Accurate diagnosis of peripartum pulmonary embolism is pertinent for reducing morbidity and mortality. Accurate diagnosis is also vital for avoiding the adverse effects of unwanted anticoagulation in pregnant mother and fetus in a patient wrongly diagnosed with this condition. Computerized tomographic pulmonary angiography has a high specificity and sensitivity in comparison to ventilation/perfusion scan for diagnosis of peripartum pulmonary embolism (PPE). It has a lower fetal radiation exposure and aids in arriving at an alternative diagnosis, if PPE is absent. Low molecular weight heparin is the medication of choice in the treatment of peripartum pulmonary embolism. Thrombolysis is considered in patients with massive PPE and hemodynamic instability, refractory hypoxia or right ventricular dysfunction. Regional anesthesia/analgesia can be given safely in these patients. We report two cases of PPE and review the anesthetic and surgical consideration.

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“…Most of these studies involved patients in Western countries. A study in Japan showed that pulmonary thromboembolism occurred in 0.02% of total births, and the mortality rate was 2.5 per 100,000 deliveries [6]. Women with pregnancy-related thrombosis tend to have inherited thrombophilia, thus the prevention of DVT during pregnancy and postpartum is important for pregnant women.…”

Section: Introductionmentioning

confidence: 99%

Genetic analysis of patients with deep vein thrombosis during pregnancy and postpartum

et al. 2011

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Deep vein thrombosis (DVT) is a serious pregnancy-related complication. Recent studies indicate that the genetic background for DVT differs with ethnicity. In our study, we enrolled 18 consecutive Japanese patients who had developed DVT during pregnancy and postpartum. We performed a genetic analysis of three candidate genes for DVT, protein S, protein C and antithrombin, in these patients. We found that four patients had missense mutations in the protein S gene, including the K196E mutation in two patients, the L446P mutation in one patient, and the D79Y and T630I mutations in one patient, as well as one patient with the C147Y mutation in the protein C gene. All five patients with genetic mutations had DVT in their first two trimesters. Nine of the patients without genetic mutations developed DVT in the first two trimesters, and four in the postpartum period. Thus, genetic mutations in the protein S gene were predominant in pregnant Japanese DVT women, and DVT in pregnant women with genetic mutations occurred more frequently at the early stage of pregnancy than postpartum. Considering the rapid decrease in protein S activity during pregnancy, we may need to assess thrombophilia in women before pregnancy.

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Pulmonary Thromboembolism in Obstetrics and Gynecology Increased by 6.5-Fold Over the Past Decade in Japan

Cited by 42 publications

References 20 publications

Safety and efficacy of thromboprophylaxis using enoxaparin sodium after cesarean section: A multi-center study in Japan

Safety and efficacy of thromboprophylaxis using enoxaparin sodium after cesarean section: A multi-center study in Japan

Peripartum pulmonary embolism: Anesthetic and surgical considerations

Genetic analysis of patients with deep vein thrombosis during pregnancy and postpartum

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