预防深静脉血栓和先兆子痫。治疗的可能性。

Annales de medecine interne Pub Date : 2003-09-01
Maryse Palot, Claire Daigremont-Botmans, Hugues Visseaux
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引用次数: 0

摘要

为了预防妊娠和产褥期深静脉血栓形成,建议使用加压袜和肝素。这些措施对母亲和婴儿都是安全的,但如果可能的话,低分子量肝素(LMWH)必须优于未分离肝素。预防子痫前期(PE)已被广泛研究。在营养成分中,补充钙能有效预防自发低钙摄入女性的PE,而补充鱼油则不然。叶酸的有效性仍然存在争议。阿司匹林已被广泛研究用于预防和治疗肺水肿。阿司匹林的有效性取决于怀孕期间的早期给药,也可能取决于剂量,而最好的效果是剂量超过60毫克/天。阿司匹林和低分子肝素的关联用于有全身性病变的患者,没有出血并发症的描述。口服抗凝剂仅用于机械心脏瓣膜患者,妊娠第6周至第12周之间的使用是有争议的,因为胎儿畸形的风险增加,而近期使用抗凝剂是因为新生儿出血的风险增加。
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[Prevention of deep vein thrombosis and preeclampsia. Therapeutic possibilities].

To prevent deep vein thrombosis during pregnancy and the puerperium, compression stockings and heparin have been proposed. These measures are safe for the mothers and their babies, however low molecular weight heparin (LMWH) must be preferred to unfractioned heparin if possible. The prevention of preeclampsia (PE) has been widely studied. Among nutrients, calcium supplementation is effective to prevent PE among women with a spontaneous low calcium intake, but fish oil supplementation is not. The effectiveness of folic acid is still controversial. Aspirin has been widely studied to prevent, and also treat, PE. The effectiveness of aspirin depends on an early administration during pregnancy and probably on the dose, while the best results have been observed with doses more than 60 mg/day. The association of aspirin and LMWH was used among patients with systemic pathologies, and no hemorrhagic complications were described. Oral anticoagulants are used only among patients with mechanical heart valves, the use between the 6th and the 12th week of pregnancy is controversial, because of an increased risk of fetal malformation, and near term because of an increased risk of neonatal hemorrhage.

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