Management and Treatment of 34 Cases of Antepartum Thromboembolism

Abstract

Summary Thirty‐four patients with antenatal venous thromboembolism seen in Dundee Royal Infirmary between 1960 and 1969 are reviewed in an attempt to define the patient at risk. No pregnant woman is immune but older parous patients with a history of venous trouble and subjected to rest in bed are likely to develop the condition. The diagnosis of deep venous thrombosis and the medical management of patients with antenatal deep venous thrombosis are discussed. There may be a place for the use of low molecular weight Dextran during labour and in the early puerperium. Although postpartum recurrence of deep venous thrombosis did not occur significantly more frequently in patients who had received stilboestrol to suppress lactation, all the cases of puerperal pulmonary embolism occurred in patients who had received either stilboestrol or hexoestrol. It appears unwise to administer substances which are known to raise blood clotting factors to patients who are already notably susceptible to venous thrombosis. Antepartum and postpartum anticoagulation regimens are suggested.

On Fibrinolysis: A. In Pregnancy, Labour, Puerperium and During Treatment with Sex Hormones B. In Human Ontogenesis and in Human Organ Culture

“…Recently in a large material Aaro 8t Juergens (1971) reported an increase during pregnancy particularly during the third trimester. A similar observation has been made by Duncan et al (1971). A disadvantage of many earlier investigations is that the methods used for diagnosing thrombosis were less satisfactory, for which reason swellings observed in late pregnancy might often have been due to undiagnosed thrombotic conditions.…”

“…(2) Immunological method by Ganrot & Nilthn (1968), as slightly modified by Ekelund et al (1970). Blood collected with EACA.…”

“…Normal range 60-Antiplasmin. Caseinolytic method by Shamash & Rimon (1964), as modified by Ekelund et al (1970). Normal range 400-600 ACU/ml.…”