Thrombolysis for Venous Thromboembolism During Pregnancy: A Literature Review

Ho, Vy T.; Dua, Anahita; Lavingia, Kedar S.; Rothenberg, Kara A.; Rao, Christina; Desai, Sapan S.

doi:10.1177/1538574418777822

Cited by 14 publications

(8 citation statements)

References 74 publications

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“…Normal pregnancy is associated with a complicated of haematological variations, resulting in a hypercoagulable state [26] . PC, PS, and ATIII are three vitamin K-dependent anticoagulant proteins that are key roles in the coagulation regulation [27] .…”

Section: Discussionmentioning

confidence: 99%

Expression and Diagnostic Value of Serum Protein Z, Protein Z-dependent Protease Inhibitor and Coagulation-related Indicators in Foetal Growth Restriction.

Luo

Huang

et al. 2020

Preprint

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Objective: This study aimed to explore the expression and associations between levels of serum protein Z (PZ), protein Z-dependent protease inhibitor (ZPI), and coagulation-related indicators and foetal growth restriction (FGR).Methods: A total of 50 pregnant women with FGR, 50 healthy pregnant women (Healthy control, HC), and 30 childbearing-age women without pregnancy group (Blank control, BC) were collected in this study. The serum PZ, ZPI, protein C (PC), protein C (PS), and antithrombin III (ATIII) levels of women in each group were determined and compared. Moreover, correlations between these indices and FGR were assessed using Spearman analysis and diagnostic values of these indices for FGR were evaluated using the receiver operating characteristics (ROC) curves.Results: Serum levels of PZ, ZPI, PC, PS, and ATIII were significantly downregulated in the HC and FGR groups compared with the BC group (P <0.001), while PZ, ZPI, PS, and ATIII levels in the FGR groups were significantly lower than that in the HC group (P <0.01). PZ serum concentration was positively correlated with ZPI concentration in the HC and FGR groups, and PZ and ZPI levels were negatively correlated with FGR (r = -0.198, r = -0.247, P <0.05). Combined of PZ, ZPI, PS, and ATIII performed a better value than each of them with AUC of 0.935 (95% CI=0.890-0.981), a sensitivity of 0.920, and a specificity of 0.800.Conclusion: Serum PZ, ZPI, PS, and ATIII were significantly decreased in pregnant women with FGR and could be used for FGR screening in pregnant women.

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Section: Discussionmentioning

confidence: 99%

Expression and Diagnostic Value of Serum Protein Z, Protein Z-dependent Protease Inhibitor and Coagulation-related Indicators in Foetal Growth Restriction.

Luo

Huang

et al. 2020

Preprint

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“…ebenfalls 11 der 13 Patienten mittels Katheter-gestützten Verfahren behandelt wurden [15]. Allerdings erscheint eine kumulative materne und fetale Komplikationsrate von 20 % der Kathetergestützten Verfahren bei Schwangeren aus einem Review zusammengetragener Fallberichte aus dem Jahr 2018 relevant [16]. Eine Evaluation der bestehenden besseren Datenlage zur operativen Thrombektomie bei Schwangeren fand keinen Einzug in die Empfehlungen der Fachgesellschaft.…”

Section: Diskussionunclassified

“…Diese Empfehlung stützt sich allerdings haupt- sächlich auf Ergebnisse der interventionellen, Katheter-gestützten CaVenT-Studie, welche an Nichtschwangeren durchgeführt wurde [14], und einer fallzahlschwachen Untersuchung, bei der ebenfalls 11 der 13 Patienten mittels Katheter-gestützten Verfahren behandelt wurden [15]. Allerdings erscheint eine kumulative materne und fetale Komplikationsrate von 20 % der Kathetergestützten Verfahren bei Schwangeren aus einem Review zusammengetragener Fallberichte aus dem Jahr 2018 relevant [16]. Eine Evaluation der bestehenden besseren Datenlage zur operativen Thrombektomie bei Schwangeren fand keinen Einzug in die Empfehlungen der Fachgesellschaft.…”

Section: Diskussionunclassified

Sonografisch assistierte venöse Thrombektomie im ersten Trimenon – ein Fallbericht

et al. 2021

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ZusammenfassungEs wird der Fall einer Patientin in der 12. Schwangerschaftswoche (SSW) mit einer deszendierenden 4-Etagen-Thrombose, welche unter konservativen stationären Maßnahmen einen Progress des Befundes erlitten hat, vorgestellt und diskutiert. Die Patientin und ihr Ehemann hatten sich trotz erhöhten Risikos für den Fötus für eine operative Rekanalisation entschieden. Die venöse Thrombektomie wurde sonografisch assistiert, ohne Anlage einer AV-Fistel, durchgeführt. Die bei Schwangeren eingeschränkten diagnostischen Möglichkeiten und Einflussfaktoren für eine Risikoevaluation für Mutter und Kind werden dargestellt.

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“…[79] A separate review of 215 cases involving the use of thrombolysis in pregnancy compared systemic (n=183) to catheter-directed (n=19) thrombolysis, reporting lower rates of both maternal (4.4% vs. 14.75%) and fetal (1.65% vs. 5.2%) complications in systemic thrombolysis vs. CDT. [80] The 2019 European Society of Cardiology guidelines suggest that "thrombolysis or surgical embolectomy should be considered for pregnant women with high-risk PE" (Class IIa/ Level C evidence). [6] Ultimately, this decision should be made on a case-by-case basis, taking into account the clinical situation at-hand and the patient's overall risk.…”

Section: Pregnancymentioning

confidence: 99%