妊娠期静脉血栓栓塞

G. Gal
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摘要

静脉血栓栓塞(VTE)是妊娠期或产后早期孕产妇发病和死亡的主要原因,它仍然是诊断和治疗的挑战。最新的孕产妇死亡保密调查显示,静脉血栓栓塞现在是仅次于败血症和高血压的第三大直接孕产妇死亡原因。特别是静脉血栓栓塞的发生率估计为每1000-2000例妊娠中有1例。孕妇患静脉血栓栓塞的风险是同龄非孕妇的五倍,产后静脉血栓栓塞比产前静脉血栓栓塞更常见。本综述旨在提供关于妊娠期静脉血栓栓塞的最新文献,强调诊断和治疗策略的最新发现,详细考虑各种技术和药物类别对母亲和胎儿的风险和益处。目前缺乏对妊娠期抗凝剂使用的大型试验,建议主要基于病例系列和专家意见。尽管如此,抗凝剂被认为可以改善目前或以前有静脉血栓栓塞的妇女的妊娠结局
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Venous Thromboembolism During Pregnancy
Venous thromboembolism (VTE) is a major cause of maternal morbidity and mortality during pregnancy or early after delivery and it remains a diagnostic and therapeutic challenge. The latest Confidential Enquiry into Maternal Deaths showed that VTE is now the third leading cause of direct maternal mortality, beside sepsis and hypertension. In particular the prevalence of VTE has been estimated to be 1 per 1000-2000 pregnancies. The risk of VTE is five times higher in a pregnant woman than in non-pregnant woman of similar age and postpartum VTE is more common than antepartum VTE. This review aimed to provide an update of whole current literature on VTE in pregnancy highlighting the most recent findings in diagnostic and therapeutic strategies, considering in detail risks and benefits of various techniques and drug classes, for both mother and fetus. Large trials of anticoagulants administration in pregnancy are lacking and recommendations are mainly based on case series and on expert opinions. Nonetheless, anticoagulants are believed to improve the outcome of pregnancy for women with current or previous VTE
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