Prophylaxis and Therapy of Venous Thrombotic Events (VTE) in Pregnancy and the Postpartum Period.

Prophylaxis and Therapy of Venous Thrombotic Events (VTE) in Pregnancy and the Postpartum Period. Geburtshilfe Frauenheilkd. 2020 Jan;80(1):48-59 Authors: Sucker C Abstract Venous thromboembolisms and pulmonary embolisms are one of the main causes of morbidity and mortality in pregnancy. The increased risk of thrombotic events caused by the physiological changes during pregnancy alone does not justify any medical antithrombotic prophylaxis. However, if there are also other risk factors such as a history of thromboses, hormonal stimulation as part of fertility treatment, thrombophilia, increased age of the pregnant woman, severe obesity or predisposing concomitant illnesses, the risk of thrombosis should be re-evaluated - if possible by a coagulation specialist - and drug prophylaxis should be initiated, where applicable. Low-molecular-weight heparins (LMWH) are the standard medication for the prophylaxis and treatment of thrombotic events in pregnancy and the postpartum period. Medical thrombosis prophylaxis started during pregnancy is generally continued for about six weeks following delivery due to the risk of thrombosis which peaks during the postpartum period. The same applies to therapeutic anticoagulation after the occurrence of a thrombotic event in pregnancy; here, a minimum duration of the therapy of three months should also be adhered to. During breastfeeding, LMWH or the oral anticoagulant warfarin can be considered; neither active substance pa...
Source: Geburtshilfe und Frauenheilkunde - Category: OBGYN Tags: Geburtshilfe Frauenheilkd Source Type: research

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Conclusion: Pregnancy was the most common provoking factor for VTE in our study. Pregnant women should undergo formal, written assessments of risk factors for VTE at the first visit and delivery. Larger studies with a randomized design, and control groups are required to confirm the current findings. PMID: 32351991 [PubMed - in process]
Source: Biomed Res - Category: Research Authors: Tags: Biomed Res Int Source Type: research
Venous thromboembolism (VTE) is a major cause of maternal morbidity and mortality. The risk of VTE is particularly elevated during the postpartum period and especially following cesarean delivery. There is considerable variation in the approach to VTE prophylaxis in pregnancy, including following cesarean delivery. The purpose of this document is to discuss the different guidelines on VTE prophylaxis following cesarean delivery and provide recommendations based on the available evidence. The following are Society for Maternal-Fetal Medicine (SMFM) recommendations: We recommend that all women who undergo cesarean delivery r...
Source: American Journal of Obstetrics and Gynecology - Category: OBGYN Authors: Tags: SMFM Consult Series Source Type: research
On March 29, 2020, a 17-year-old obese woman (BMI 32 Kg/m2) was admitted at 29  weeks of gestation to our COVID-19 Maternity Hub in Milan for fever, mild dyspnea and rhinitis in the last three days. Her past medical history was unremarkable and she had a negative family history of venous thromboembolism. Her body temperature was 37.3 °C, heart and respiratory rates, and o xygen saturation were normal. A nasopharyngeal swab revealed a SARS-CoV-2 infection. On March 30, her respiratory function suddenly worsened and she started oxygen supplementation with 2 l per minute via nasal cannula.
Source: Thrombosis Research - Category: Hematology Authors: Tags: Letter to the Editors-in-Chief Source Type: research
​BY JENNIFER TUONG; IVAN KHARCHENKO; JEAN LUC AGARD; &AHMED RAZIUDDIN, MDA 65-year-old man who had HIV well-controlled with highly active antiretroviral therapy, hypertension, sciatica, and restless leg syndrome presented to the emergency department with left leg pain. He also had had chemotherapy and radiation for anal cancer. The patient said the pain had started 45 minutes earlier when he was sitting on the toilet.He described the pain as sore in quality and 10/10 on the pain scale. He reported that it had started in his lower back and radiated to his left leg. He said he had had no trauma or weakness to the regio...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
Abstract Virchow's triad has been known for a 100 years. The development of therapeutic possibilities during this time was enormous. Today anticoagulant therapy is much more differentiated. Four new oral substances have replaced the traditional treatment with vitamin K antagonists in angiology. A standardized dosage is available. The monitoring of the coagulation parameters is no longer necessary, but it is important to monitor renal function. Direct oral anticoagulants are approved for the treatment of venous thrombosis and pulmonary embolism, but not during pregnancy or in children. Severe bleedin...
Source: Hamostaseologie - Category: Hematology Authors: Tags: Internist (Berl) Source Type: research
Discussion Infant size at birth is determined mainly by genetics, but also pregnancy and environmental factors. Large for gestational age (LGA) is defined as a mean weight> 2 standard deviations above the weight for gestational age or above the 90th percentile on growth charts (or ~4000 g on WHO growth charts). Macrosomia is a term used for a term infant who is> 4000g. Risk factors for LGA infants includes: Male infant Maternal Genetic disposition Hispanic ethnicity Diabetic Multiparity or grand parity Obesity History of previous LGA infant Prenatal ultrasound is very helpful for antenatal management. First tri...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
​BY FREDDIE IRIZARRY-DELGADO; VAROON KAKAIYA; &AHMED RAZIUDDIN, MDAn 86-year-old African-American woman was brought to the ED by her daughter after two days of nutritional neglect, abdominal pain, and altered mental status. Her daughter said her mother felt lightheaded, appeared dehydrated, and vomited nonbilious watery fluid once. The patient had a history of diabetes mellitus type 2, DVT/PE, dementia, and early signs of parkinsonism.Her vital signs were remarkable only for tachypnea (24 bpm). Her troponin I was markedly elevated at 1.7 ng/mL. A D-dimer was ordered because of her history of unprovoked DVT/PE, and it...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
(CNN) — In what researchers are calling “the largest genetic study ever performed” on varicose vein disease, a Stanford University School of Medicine study found a person’s height to be a significant risk factor for developing varicose veins. “We not only found an association between height and varicose veins, but the genetic studies we did showed a causal link,” said cardiologist and study author Dr. Nicholas Leeper, an associate professor of surgery and cardiovascular medicine at Stanford. “That suggests that the genes and pathways that drive human height are also likely to be ca...
Source: WBZ-TV - Breaking News, Weather and Sports for Boston, Worcester and New Hampshire - Category: Consumer Health News Authors: Tags: Health News Local TV Varicose Veins Source Type: news
We reported a case of a 41-year-old woman who died during sexual activity. The autopsy findings highlighted the presence of massive pulmonary embolism. Histopathological analysis showed structural anomalies of the thyroid gland. A retrospective analysis of her medical history and possible genetic alterations were performed.
Source: The American Journal of Forensic Medicine and Pathology - Category: Forensic Medicine Tags: Case Report Source Type: research
Abstract Pulmonary embolism and deep venous thrombosis are the two most important manifestations of venous thromboembolism (VTE), which is the third most common life-threatening cardiovascular disease in the United States. Anticoagulation is the mainstay of VTE treatment. Most patients with deep venous thrombosis or low-risk pulmonary embolism can be treated in the outpatient setting with low-molecular-weight heparin and a vitamin K antagonist (warfarin) or direct-acting oral anticoagulants. Inpatient treatment of VTE begins with parenteral agents, preferably low-molecular-weight heparin. Unfractionated heparin is...
Source: American Family Physician - Category: Primary Care Authors: Tags: Am Fam Physician Source Type: research
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