Prevention and Treatment of Arterial Thrombosis in Pregnancy

Clark, Peter; Greer, Ian A.

doi:10.1055/s-2003-38830

Cited by 14 publications

(7 citation statements)

References 78 publications

(90 reference statements)

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“…Both STB and trophoblast cells are a robust source of tissue factor (TF), the key initiator of hemostasis. 6 The documented presence of placental fibrin depositions in normal pregnancies 7 suggests that activation of coagulation may be a favored process for handling hemorrhages during pregnancy or at delivery. Increased levels of thrombin-antithrombin III complex, a marker of in vivo thrombin formation, has been reported in blood from the uterine vein of normotensive pregnancies compared with levels drawn from the antecubital vein.…”

mentioning

confidence: 99%

Global Hemostasis in Pregnancy: Are We Using Thromboelastography to Its Full Potential?

Othman

Falcon

Kadir

2010

Semin Thromb Hemost

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Pregnancy is a unique situation where significant physiological changes in all maternal organ systems take place. Most of these changes return to normal after delivery. During normal pregnancy the hemostatic balance changes in the direction of hypercoagulability, thus decreasing bleeding complications at time of delivery. The pregnancy-associated hypercoagulability sets a foundation for hemostatic abnormalities during pregnancy and may be associated with pregnancy complications. Assessment of the hemostatic status in pregnancy and its complications can be critical to diagnosis and management not only within the obstetric ward but in trauma, anesthesia, and other situations. Conventional global tests such as prothrombin time and activated partial thromboplastin time cannot define this status appropriately, and full assessment requires measurements of several parameters. Thromboelastography (TEG) is a global hemostatic test that can analyze both coagulation and fibrinolysis. The technique has been available since the 1940s, but only recently has it shown great impact within the clinical practice arena. TEG measures the interactive dynamic coagulation process from the initial fibrin formation to platelet interaction and clot strengthening to fibrinolysis, which makes it superior to other conventional tests. In addition, TEG can guide therapy by documenting changes in coagulation in vitro before a therapy is instituted and also by helping the clinician make critical decisions. Despite the clear value as a test for monitoring hemostatic status of pregnancy-related complications, TEG is still underused for reasons such as poor awareness regarding the technique and interpretations, lack of full standardization, and the unavailability of large clinical studies. However, the fact remains that TEG is undoubtedly attractive to both researchers and clinicians, particularly in a point-of-care setting. We hope that much more investment is directed to TEG studies in both experimental and clinical fields to improve applications and promote use, especially with respect to clinical decision making in pregnancy-related complications.

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mentioning

confidence: 99%

Global Hemostasis in Pregnancy: Are We Using Thromboelastography to Its Full Potential?

Othman

Falcon

Kadir

2010

Semin Thromb Hemost

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“…In case of previous AT and aspirin prophylaxis, we suggest to continue unchanged medication throughout IVF treatment, pregnancy, and postpartum without a break. [34][35][36][37] Clinical Advice…”

Section: Suggested Management Strategies For Women With a Previous Vt Undergoing Artmentioning

confidence: 99%

Prior Thromboembolic Disease and Assisted Reproductive Therapy

Jacobsen

Sandset

2021

Semin Reprod Med

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Assisted reproductive therapy (ART) increases the risk of venous thrombosis (VT) by 2- to 4-fold, whereas pregnancy increases the risk by 5- to 10-fold. Women with a history of VT undergoing ART are often suggested thromboprophylaxis. The literature is scarce and international guidelines are lacking. We made a review of the literature and base our suggestions primarily on expert opinions. We suggest women with a prior VT to use low-molecular-weight heparin as thromboprophylaxis starting from ovarian stimulation, throughout pregnancy, and 6 weeks postpartum. Assessment of VT risk should be done prior to ART. Adjustment of treatment to minimize the thrombotic risk, such as preventing ovarian hyperstimulation syndrome, single-embryo transfer, cryopreservation, and transfer of frozen embryos instead of fresh embryo in high-risk women, is suggested. Women with previous arterial thrombosis should continue aspirin during ART treatment, pregnancy, and postpartum.

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“…Nach Datenlage internationaler Studien und Therapieleitlinien ist die Gabe von ASS in niedriger Dosierung (<150 mg mg pro Tag) nach dem I. Trimenon und bis zur 37. SSW als sicher anzusehen [1,7,8,9]. Über die 37.…”

Section: Anwendungsbeschränkungen Von Assunclassified

Anwendungsbeschränkung von Aspirin während der Schwangerschaft

Scharf

Beck

2009

Gynäkologe

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Prevention and Treatment of Arterial Thrombosis in Pregnancy

Cited by 14 publications

References 78 publications

Global Hemostasis in Pregnancy: Are We Using Thromboelastography to Its Full Potential?

Global Hemostasis in Pregnancy: Are We Using Thromboelastography to Its Full Potential?

Prior Thromboembolic Disease and Assisted Reproductive Therapy

Anwendungsbeschränkung von Aspirin während der Schwangerschaft

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