Recommendations for the Diagnosis and Treatment of Deep Venous Thrombosis and Pulmonary Embolism in Pregnancy and the Postpartum Period

McLintock, Claire; Brighton, Tim; Chunilal, Sanjeev; Dekker, Gus; McDonnell, Nolan; McRae, Simon; Muller, P.; Tran, H. Nicole; Walters, Barry N J; Young, Laura

doi:10.1097/01.aoa.0000426070.33714.49

Cited by 8 publications

(9 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Fakat gebelik ve postpartum dönemde D-dimer düzeyleri yüksek seyredeceği için DVT değerlendirilmesinde önerilmemektedir (25) .…”

Section: Gebeli̇kte Venöz Tromboemboli̇ Tani Ve Tedavi̇si̇unclassified

Venous thromboembolism in pregnancy and nursing care

Akarsu¹,

Öskay²

2015

MedJ

View full text Add to dashboard Cite

GİRİŞVenöz tromboemboli, venöz dolaşımda oluşan tüm patolojik trombozların genel adıdır. En sık olarak alt ekstremite derin venlerinde görülür ve derin ven trombozuna (DVT), üst ekstremite, pelvis ve diğer venlerde görüldüğünde ise pulmoner emboliye (PE) neden olabilir. Venöz tromboembolitik olayların %80'ini DVT, %20'sini PE oluşturmaktadır (1) .Venöz tromboemboli pek çok ülkede gebelik ve doğum sonrası dönemin en önemli mortalite ve morbidite nedenlerindendir. Gebelerde, tüm maternal mortalitenin yaklaşık %10'una venöz tormboemboli neden olmaktadır. Venöz tromboemboli insidansı bin doğumda iki, venöz tromboemboliye'ye bağlı ölüm oranı ise yüz bin doğumda bir olarak belirtilmektedir (2) .Gebelikte plazma fibrinojen düzeyi %50 civarında yükselmekte ve bu nedenle gebelik trombojenik özel-liktedir (3,4) . Gebelikte koagülasyon faktörlerinin artmasıyla birlikte doğal antikoagülanlar ve fibrinolitik aktivitede azalma olmaktadır. Ayrıca büyüyen uterus nedeniyle venöz dönüşün artması, artmış östrojen ve

show abstract

“…Fakat gebelik ve postpartum dönemde D-dimer düzeyleri yüksek seyredeceği için DVT değerlendirilmesinde önerilmemektedir (25) .…”

Section: Gebeli̇kte Venöz Tromboemboli̇ Tani Ve Tedavi̇si̇unclassified

Venous thromboembolism in pregnancy and nursing care

Akarsu¹,

Öskay²

2015

MedJ

View full text Add to dashboard Cite

show abstract

“…Diferentes grupos de trabajo y sociedades han desarrollado guías acerca del tema, considerando al tromboembolismo venoso como una causa mayor de morbilidad y mortalidad en el periodo posparto y, también, reconociendo la falta de estudios al respecto (10)(11)(12).…”

Section: Introductionunclassified

Factores de riesgo y clasificación de riesgo para enfermedad tromboembólica en mujeres posparto

Espinel

Mesa

Jiménez

et al. 2020

Revista Investig. Salud Univ. Boyacá

View full text Add to dashboard Cite

Introducción. Las mujeres en el periodo posparto presentan un mayor riesgo de morbilidad y mortalidad, con un incremento de hasta 10 veces el riesgo de enfermedad tromboembólica, en comparación con mujeres no embarazadas en edad fértil. Objetivo. Describir las características sociodemográficas, factores de riesgo y clasificación de riesgo para eventos tromboembólicos de las mujeres posparto en un hospital de referencia del departamento de Boyacá durante el año 2018. Metodología. Estudio observacional, descriptivo, de corte transversal, realizado en 398 mujeres posparto, quienes fueron encuestadas y valoradas por el servicio de ginecobstetricia del Hospital Regional de Sogamoso, durante el año 2018; se identificaron los factores y se hizo clasificación de riesgo para eventos tromboembólicos. Resultados y conclusiones. Las mujeres posparto cuentan con una mediana de edad de 26 años [RIQ; 10 años], procedentes del área urbana en el 62,6% y en su mayoría (69,6%) del estrato socioeconómico uno. Los factores de riesgo más frecuentes encontrados fueron la cesárea (33,2%), el sobrepeso (31,4%), la obesidad grado I y II (11,3%) y el parto pretérmino (7,5%). La clasificación de riesgo para eventos tromboembólicos en el total de la población se clasificó como: 6% riesgo bajo, 89,5% riesgo moderado y 4,5% riesgo alto. Es necesario contar en los servicios de ginecobstetricia con la identificación del nivel de riesgo para eventos tromboembólicos de las mujeres posparto, de forma estandarizada y sistemática; igualmente, mitigar estos riesgos y así garantizar la prevención de este tipo de complicaciones.

show abstract

“…11 They do not carry the teratogenic risk of vitamin K antagonists and, compared to unfractionated heparin, have a longer half-life, more predictable PK and less risk of heparininduced thrombocytopenia or osteoporosis. 1,2,11,12 Anticoagulation in pregnancy for non-VTE indications has been widely debated in the literature due to the potentially critical maternal and foetal outcomes. 5,8,13,14 Recent consensus guidelines recommend that anticoagulation should be dose-individualised for each woman; however, few data exist regarding how to achieve specific and safe dosing and monitoring strategies.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of therapeutic enoxaparin in a pregnant population at a tertiary hospital

Petrie

Barras

Lust

et al. 2016

Internal Medicine Journal

View full text Add to dashboard Cite

Background Therapeutic anticoagulation with enoxaparin in pregnancy is complex due to varying pharmacokinetics and the increasing prevalence of obesity. There is limited evidence to support current dosing and monitoring strategies of enoxaparin in this population. Aim To describe the current practice in therapeutic anticoagulation in the pregnant population at a tertiary institution. Methods A retrospective study of pregnant women on therapeutic enoxaparin between January 2007 and December 2011. Results Forty‐four pregnant women requiring therapeutic anticoagulation were identified and divided into two groups, monitored with anti‐factor Xa (AXA) concentrations and unmonitored. Fifty‐five percent of monitored women were initiated on the recommended 1 mg/kg twice a day (bd) enoxaparin dose‐strategy. Eighty‐two percent of women were monitored; however, there was variability regarding the timing, frequency and subsequent dose adjustments from monitoring. Overall, as pregnancies progressed, there was both increasing dose adjustments and increasing frequency of monitoring. Fourteen women had a BMI over 30 kg/m2, and 13 of these women were monitored. Nine monitored obese women required doses less than 1 mg/kg/bd to maintain a therapeutic AXA level. Management appeared to be individualised. There were small numbers of toxicity events. Conclusion Variation exists in dosing and monitoring practices for therapeutic enoxaparin in the pregnant population. Dosing obese patients using 1 mg/kg twice daily can lead to toxic AXA concentrations, and dose reductions are required to maintain a therapeutic range. A larger prospective study reviewing dose, AXA concentrations and outcome data is necessary to make dosing recommendations in this group.

show abstract

Recommendations for the Diagnosis and Treatment of Deep Venous Thrombosis and Pulmonary Embolism in Pregnancy and the Postpartum Period

Cited by 8 publications

References 0 publications

Venous thromboembolism in pregnancy and nursing care

Venous thromboembolism in pregnancy and nursing care

Factores de riesgo y clasificación de riesgo para enfermedad tromboembólica en mujeres posparto

Evaluation of therapeutic enoxaparin in a pregnant population at a tertiary hospital

Contact Info

Product

Resources

About