Risque thrombotique des grossesses après un épisode de thrombose veineuse cérébrale

Pourrât, O.; Neau, J.-P.; Pouget-Abadie, J.-F.; Pierre, Fabrice H.F.

doi:10.1016/j.revmed.2013.08.002

Cited by 3 publications

(3 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Finally, we included 13 studies: 8 studies with long-term follow-up of patients with CVT [16][17][18][19][20][21][22][23] and 5 studies evaluating complications during subsequent pregnancies in women with previous cerebrovascular disease. [24][25][26][27][28] The remaining studies were excluded because of lack of information on the course of pregnancies occurring in women with previous CVT or for providing insufficient data for calculation of rates of thrombotic events and abortion. A MOOSE/PRISMA flowchart summarizes study selection (Figure).…”

Section: Resultsmentioning

confidence: 99%

“…Дополнительные исследования выявили в результате проведенного ручного поиска среди ссылок в выявленных работах для изучения полного текста работ. В окончательный анализ включили 13 исследований: 8 исследований с длительным периодом наблюдения за пациентками с ЦВТ [16][17][18][19][20][21][22][23] и 5 исследований по оценке осложне-ний во время последующей беременности у женщин с цереброваскулярной патологией в анамнезе [24][25][26][27][28]. Остальные исследования были исключены из-за отсутствия данных о течении беременности у женщин с ЦВТ в анамнезе или по причине предоставления недостаточного количества данных для расчета часто-ты тромбообразования и самопроизвольных абортов.…”

Section: ■ результатыunclassified

See 1 more Smart Citation

Safety of Pregnancy After Cerebral Venous Thrombosis

Sousa

Canhão

Ferro

2016

Stroke

View full text Add to dashboard Cite

Background and Purpose-Pregnancy and puerperium are associated with an increased risk of venous thrombotic events (VTEs), including cerebral venous thrombosis (CVT). We aimed to systematically review, in pregnant woman with previous CVT, (1) the risk of recurrence of CVT or other VTE; (2) the result of pregnancy; and (3) the association of antithrombotic prophylaxis with these outcomes. Methods-We searched MEDLINE, Cochrane Database of Systematic Reviews, clinicaltrials.gov (from inception to July 2015), and reference lists of included studies and review articles. We considered observational studies reporting original data on the frequency of CVT or other VTE associated with pregnancy or puerperium in women with history of CVT. Results-Thirteen studies were included. A simple pooled analysis of individual patient data and meta-analysis of proportions using a random effect model were performed. (1)

show abstract

Section: Resultsmentioning

confidence: 99%

Section: ■ результатыunclassified

Safety of Pregnancy After Cerebral Venous Thrombosis

Sousa

Canhão

Ferro

2016

Stroke

View full text Add to dashboard Cite

show abstract

“…A systematic review of published observational studies which together reported 217 pregnancies 5,50,53,81,86,90,93,[190][191][192][193][194][195] found a low absolute risk of pregnancy related venous thrombosis (9 CVT and 27 non-cerebral VTE per 1000 pregnancies) but a significantly higher rate of both recurrent CVT and other VTEs, comparing with the baseline risk described in the general population for pregnant women. 196 These results probably underestimate the true incidence because a large proportion of women included in these cohorts were receiving antithrombotic prophylaxis during pregnancy and/or puerperium.…”

mentioning

confidence: 98%

European Stroke Organization guideline for the diagnosis and treatment of cerebral venous thrombosis – Endorsed by the European Academy of Neurology

Ferro

Bousser

Canhão

et al. 2017

European Stroke Journal

182

103

View full text Add to dashboard Cite

The current proposal for cerebral venous thrombosis guideline followed the Grading of Recommendations, Assessment, Development, and Evaluation system, formulating relevant diagnostic and treatment questions, performing systematic reviews of all available evidence and writing recommendations and deciding on their strength on an explicit and transparent manner, based on the quality of available scientific evidence. The guideline addresses both diagnostic and therapeutic topics. We suggest using magnetic resonance or computed tomography angiography for confirming the diagnosis of cerebral venous thrombosis and not screening patients with cerebral venous thrombosis routinely for thrombophilia or cancer. We recommend parenteral anticoagulation in acute cerebral venous thrombosis and decompressive surgery to prevent death due to brain herniation. We suggest to use preferentially low-molecular weight heparin in the acute phase and not using direct oral anticoagulants. We suggest not using steroids and acetazolamide to reduce death or dependency. We suggest using antiepileptics in patients with an early seizure and supratentorial lesions to prevent further early seizures. We could not make recommendations due to very poor quality of evidence concerning duration of anticoagulation after the acute phase, thrombolysis and/or thrombectomy, therapeutic lumbar puncture, and prevention of remote seizures with antiepileptic drugs. We suggest that in women who suffered a previous cerebral venous thrombosis, contraceptives containing oestrogens should be avoided. We suggest that subsequent pregnancies are safe, but use of prophylactic low-molecular weight heparin should be considered throughout pregnancy and puerperium. Multicentre observational and experimental studies are needed to increase the level of evidence supporting recommendations on the diagnosis and management of cerebral venous thrombosis. KeywordsCerebral venous thrombosis, dural sinus thrombosis, Grading of Recommendations, Assessment, Development, and Evaluation, angiography, venography, D dimers, prothrombotic screening, cancer screening, anticoagulation, heparin, thrombolysis, thrombectomy, acetazolamide, steroids, decompressive surgery, hemicraniectomy, lumbar puncture, shunt, pregnancy, puerperium, contraception, antiepileptic drugs These guidelines followed the traditional methodology of combining review of scientific evidence with expert opinion and classifying evidence and recommendations in complex grading systems, using a matrix combining classes of recommendations with levels of evidence.Since 2010-2011 new information has accumulated on multiple aspects of the diagnosis and management of CVT. We aim to update previous EFNS guidelines using a clearer and evidence base methodology. To achieve that aim, the current proposal for CVT guidelines followed the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system, 3 formulating relevant diagnostic and treatment questions, performing systematic reviews of all available eviden...

show abstract

Obstetrical history of women with cerebral vein thrombosis: outcome of the pregnancies before and after the thrombotic event

et al. 2017

View full text Add to dashboard Cite

Cerebral vein thrombosis (CVT) is a rare disease usually affecting young people, especially women, with a high prevalence of thrombophilic defects. It is known that thrombophilia is associated with pregnancy complications; therefore, a high rate of complications could be expected in women with the previous CVT who become pregnant. This study examined the whole obstetric history of women who suffered from CVT to evaluate the incidence of pregnancy complications during their entire lifespan. We prospectively followed consecutive patients with CVT, limiting the analysis to females and their obstetrical history. We studied 123 pregnancies in 99 consecutive women who had a CVT; 71 women had 91 pregnancies before the CVT; 19 women had 23 pregnancies after the CVT; and nine women had a CVT related to pregnancy. All women with CVT before pregnancy were treated with LMWH at prophylactic dosage during pregnancy. No recurrent CVT, venous thromboembolic events, or death was recorded during the observed pregnancies. Ten miscarriages were recorded (rate 8.1%), with a rate similar to that expected in the general population. We confirm the favorable outcome of pregnancies in women who suffered from CVT during their entire lifespan, whether they have occurred before and after or in relation to CVT.

show abstract

Risque thrombotique des grossesses après un épisode de thrombose veineuse cérébrale

Cited by 3 publications

References 31 publications

Safety of Pregnancy After Cerebral Venous Thrombosis

Safety of Pregnancy After Cerebral Venous Thrombosis

European Stroke Organization guideline for the diagnosis and treatment of cerebral venous thrombosis – Endorsed by the European Academy of Neurology

Obstetrical history of women with cerebral vein thrombosis: outcome of the pregnancies before and after the thrombotic event

Contact Info

Product

Resources

About