Risk factors for and clinical management of venous thromboembolism during pregnancy.
Risk factors for and clinical management of venous thromboembolism during pregnancy. Clin Adv Hematol Oncol. 2019 Jul;17(7):396-404 Authors: Rybstein MD, DeSancho MT Abstract Venous thromboembolism (VTE), which comprises deep vein thrombosis and pulmonary embolism, is one of the leading causes of non-obstetric maternal death in the United States. Physiologic and anatomic changes associated with pregnancy set the stage for a hypercoagulable state. In addition, other risk factors-including those associated with certain fetal characteristics such as low birth weight or stillbirth-have been correlated with an increased risk for VTE. Women with a personal or strong family history of VTE, as well as documented thrombophilia, represent a unique group in whom antepartum and/or postpartum prophylaxis can be considered. The choice of anticoagulant therapy for either treatment or prophylaxis in most cases is heparin, most commonly low-molecular-weight heparin. This is owing to the fact that vitamin K antagonists and the direct oral anticoagulants are contraindicated in pregnancy because of potential teratogenicity. With careful management and vigilant monitoring, appropriate anticoagulation can be used safely and effectively to improve patient outcomes. PMID: 31449506 [PubMed - in process]
Conclusion: Chinese women had a substantially lower risk of venous thromboembolism during pregnancy and the postpartum period compared to that of Caucasians. The occurrence of pregnancy-related venous thromboembolism was largely confined to the early pregnancy period, probably related to the adoption of thromboprophylaxis, a lower rate of Cesarean section, and early mobilization. PMID: 31730677 [PubMed]
We present the case report of a 26-year-old woman who became pregnant following the successful treatment of severe CTEPH by utilizing BPA. We conclude that patients undergoing effective BPA for CTEPH can consider becoming pregnant if followed closely by a multidisciplinary team, including experts in thrombosis, pulmonary hypertension and obstetrics.
This study used a descriptive phenomenological approach to explore the lived experience of women diagnosed with VTE in pregnancy and the perinatal period. The study setting was a London, university affiliated hospital. The sample consisted of nine women with deep vein thrombosis or pulmonary embolism in pregnancy or up to six weeks post-partum, diagnosed in the last two years. Semi-structured interviews were undertaken using an interview guide. Interviews were transcribed and analysed using phenomenological descriptive analysis.
CONCLUSIONS: Catheter-directed thrombolysis is preferred to systemic thrombolytic therapy in pregnant patients with massive pulmonary embolism requiring thrombus removal. PMID: 31599843 [PubMed - as supplied by publisher]
ConclusionsOur method supported or altered clinical decision-making and treatment in this cohort. A diagnostic tool for PE without intravenous contrast agent or radiation is of great benefit for certain patients.
Authors: James J, Thulaseedharan NK, Jayachandran NV, Geetha P Abstract Lemierres syndrome (LS) refers to suppurative thrombophlebitis of internal jugular vein (IJV) secondary to oropharyngeal infection. It is caused by the anaerobic bacteria Fusobacterium necrophorum. Here we report a case of LS secondary to retropharyngeal abscess in a pregnant lady with possible underlying connective tissue disorder. A 19-year old primigravida at 6-weeks of gestation, presented with fever, cough, dyspnea, right sided neck pain and swelling. Imaging showed right lower lobe pneumonia with bilateral pulmonary infiltrates and pleura...
Pregnancy and inflammatory bowel disease (IBD) are independent risk factors for venous thromboembolism (VTE). Nevertheless, the optimal VTE prevention strategy for women with IBD in pregnancy and postpartum period has not been established yet. We assessed VTE risks during pregnancy and the postpartum period in women with IBD through systematic review and meta-analysis. Systematic searches were conducted in MEDLINE (Ovid), Embase (Ovid), CENTRAL (Ovid), and Web of Science (Tomson Reuters) from the database inception till May 2017 to identify relevant studies reporting the risk of VTE during pregnancy and/or the postpartum ...
This study aimed to evaluate a pregnancy-adapted version of the YEARS algorithm for the management of suspected pulmonary embolism during pregnancy.
CONCLUSION: AC treatment patterns vary by patient population, geographic region and site of VTE. Guidelines for AC therapy are not always adhered to. This article is protected by copyright. All rights reserved. PMID: 31220403 [PubMed - as supplied by publisher]
Semin Thromb Hemost DOI: 10.1055/s-0039-1692702Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by the presence of antiphospholipid antibodies, vascular thrombosis (venous, arterial, or small vessels), and/or pregnancy morbidity. Diagnosis of APS is based on the presence of at least one clinical criterion (thrombotic events or pregnancy morbidity) and at least one of the laboratory criteria (persistently medium/high titer immunoglobulin G [IgG]/immunoglobulin M [IgM] anticardiolipin antibodies, and/or medium/high titer IgG/IgM anti-β2-glycoprotein I antibodies, and/or a positive lupus anticoagul...