Antithrombotic therapy and pregnancy: consensus report and recommendations for prevention and treatment of venous thromboembolism and adverse pregnancy outcomes

Duhl, Adam J.; Paidas, Michael J.; Ural, Serdar H.; Branch, Ware; Casele, Holly L.; Cox-Gill, Joan; Hamersley, Sheri L.; Hyers, Thomas M.; Katz, Vern L.; Kuhlmann, Randall S.; Nutescu, Edith A.; Thorp, James A.; Zehnder, James L.

doi:10.1016/j.ajog.2007.04.022

Cited by 166 publications

(71 citation statements)

References 155 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Patients on prophylactic heparin during pregnancy should maintain the treatment for 6 weeks after birth [56, 57••]. Those patients with APS and prior thrombosis or stroke should maintain anticoagulation for life and switch heparin for warfarin, which is minimally secreted into the breast milk and thus is safe to use during breastfeeding [58], as well as heparin and aspirin. [2,59].…”

Section: Postpartum Periodmentioning

confidence: 99%

Management of Obstetric Antiphospholipid Syndrome

de Jesus,

dos Santos,

Oliveira

et al. 2011

Curr Rheumatol Rep

View full text Add to dashboard Cite

Recurrent early miscarriages (excluding chromosomal anomalies), late fetal loss, and maternal thrombosis are characteristic of obstetric antiphospholipid syndrome (APS). Obstetric complications such as preeclampsia, fetal growth restriction, premature delivery, and fetal death also occur in higher frequency in APS patients than in the general population. A high-risk obstetric center is needed for proper evaluation of and intervention with pregnant women with APS. Association with lupus carries additional risk of thrombosis when antiphospholipid antibodies (aPLs) are present. Gestational results with live births are improved to about 80% when antithrombotic therapy is used, but failure in 20% to 30% of the cases despite correct treatment with low-dose aspirin with or without heparin reveals new pathways for pregnancy loss in APS and unmet needs. At the moment, there is no recommendation to investigate patients with infertility for the presence of aPLs.

show abstract

Section: Postpartum Periodmentioning

confidence: 99%

Management of Obstetric Antiphospholipid Syndrome

de Jesus,

dos Santos,

Oliveira

et al. 2011

Curr Rheumatol Rep

View full text Add to dashboard Cite

show abstract

“…[7,18] 2 [1,[2][3][4]5] Anté natal Hé morragie du postpartum [18] 1 à 4 ? Race noire [18] 1,4 [1,2-1,6] Anté /postnatal Race asiatique [18] 0,7 [0,5-0,9] Anté /postnatal Groupes A et AB [17,19] 2 [1,[3][4]3] Anté /postnatal Cé sarienne urgente [7,16] 4 [3][4][5]3] Postnatal Diabè te [8,18] 3 [1,[4][5][6][7][8]9] Anté natal Lupus [16,18] 8,7 [5,[8][9][10][11][12][13] Anté /postnatal Maladies inflammatoires [18] 6,7 [4,[4][5][6][7][8][9][10] Anté /postnatal Anté cé dent personnel MVTE unique [18] 25 …”

Section: E´pide´miologie De La Maladie Veineuse Thromboemboliqueunclassified

“…Si cette hé morragie s'accompagne d'un geste chirurgical, le risque pourrait être majoré avec un OR de 12 [8]. La pré sence d'un Lupus é rythé mateux dissé miné : Il est mis en é vidence comme facteur de risque dans certaines é tudes [16,18], OR 8,7 (5,(8)(9)(10)(11)(12)(13), mais les autres cohortes ne le mettent pas en é vidence. La maladie inflammatoire : cette situation peu fré quente n'est pas toujours bien dé finie, mais James et al montrent que les femmes enceintes atteintes ont 6,7 (4,4-10) fois plus de risque en « post-partum » que les femmes non atteintes [18].…”

Section: Facteurs De Risque Cliniques De La Maladie Veineuse Thromboeunclassified

“…De plus, les analyses multivarié es ne sont pas toujours disponibles et l'indé pendance des facteurs de risque identifié s n'est ainsi pas souvent mesuré e. La seconde partie de la pré vention de ces é vé nements morbides passe par la mise en route d'un traitement, prophylactique ou curatif. Nous exposerons ici les nombreuses recommandations sur l'usage des agents antithrombotiques [9,10].…”

Section: Introductionunclassified

See 1 more Smart Citation

Actualités sur les facteurs de risque et la prévention des complications thrombotiques de la grossesse

Chauleur

Gris

Seffert

et al. 2012

Gynécologie Obstétrique & Fertilité

View full text Add to dashboard Cite

“…Both mutations are well-established risk factors for venous thromboembolism during pregnancy and postpartum in Caucasian populations. Several prophylactic therapies for pregnant women, such as heparin administration in the perinatal period, are recommended based on the type of thrombophilia and history of thrombosis [9]. However, these two genetic mutations are not found in the Japanese population [10,11].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2011

View full text Add to dashboard Cite

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.

show abstract

Antithrombotic therapy and pregnancy: consensus report and recommendations for prevention and treatment of venous thromboembolism and adverse pregnancy outcomes

Cited by 166 publications

References 155 publications

Management of Obstetric Antiphospholipid Syndrome

Management of Obstetric Antiphospholipid Syndrome

Actualités sur les facteurs de risque et la prévention des complications thrombotiques de la grossesse

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

Contact Info

Product

Resources

About