Antithrombotic prophylaxis during pregnancy

Czech version

Authors: M. Penka ¹; P. Ďulíček ²; T. Binder ³
Authors‘ workplace: Oddělení klinické hematologie FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Miroslav Penka, CSc. ¹; Oddělení klinické hematologie II. interní kliniky Lékařské fakulty UK a FN Hradec Králové, přednosta prof. MUDr. Jaroslav Malý, CSc. ²; Gynekologicko‑porodnická klinika 2. lékařské fakulty UK a FN Motol Praha, přednosta doc. MUDr. Lukáš Rob, CSc. ³
Published in: Vnitř Lék 2009; 55(3): 211-215
Category: 15th Parizek's Days

Overview

Coagulation disturbances with their symptoms of thromboembolic –⁠ especially venous –⁠ disease play the most important role in the incidence of maternal mortality. The attention is focused on precise diagnostic procedures and on the treatment of all the disorders generally accompanied by coagulopathies. First-degree step is prevention of above mentioned complications, and the aim of its treatment is prevention of longterm complication or consequences. Actually is VTE resolved under the condition of the recommendation of 8th ACCP Conference.

Key words:
thrombosis –⁠ embolism –⁠ pregnancy –⁠ antithrombotic therapy –⁠ heparin

Sources

1. Bates SM, Greer IA, Pabinger I et al. Venous thrombembolism, Thrombophilia, Antithrombotic Therapy, and Pregnancy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th ed). Chest 2008; 133 : 844S–886S.

2. Binder T. Prevence trombembolické nemoci v těhotenství. Komentář. Gynekologie po promoci 2005; 1 : 8–11.

3. Buliková A, Crha I. Antifosfolipidové protilátky a antifosfolipidový syndrom v porodnictví. Prakt Gyn 2004; 1 : 6–10.

4. Chang J, Elam Evans LD, Berg CJ et al: Pregnancy‑related mortality surveillance: United States, 1991–1999. MMWR Surveill Summ 2003; 52 : 1–88.

5. Dulíček P, Penka M, Binder T et al. Návrh antitrombotické profylaxe a péče o trombofilní stavy v gynekologii a porodnictví. Vnitř Lék 2006; 52 (S1): 58–40.

6. Gherman RB, Goodwin TM, Leung B. Incidence, clinical characteristics, and Timing of objectively diagnose venous thrombembolism during pregnancy. Obstet Gynecol 1999; 94 : 730–734.

7. Ginsberg JS, Brill-Edwards P, Johnston M et al. Relationship of antiphospholipid antibodies to pregnancy loss in patients with systemic lupus erythematosis: a Gross-sectinal study. Blood 1992; 80 : 975–980.

8. Ginsberg JS, Greer IA, Hirsh J. Use of antithrombotic agents during pregnancy. Chest 2001; 119 (Suppl 1): 122S–131S.

9. Greer IA. Thrombosis in pregnancy: Maternal and fetal issues. Lancet 1999; 353 : 1258–1265.

10. Hirsh J. Guidelines for Antithrombotic Therapy. 8th ed. Hamilton: BC Decker Inc. 2008 : 1–180.

11. Janků K, Penka M. Gravidita při trvalé antikoagulační léčbě. Kardio 1988; 14 : 46–51.

12. Janků K, Penka M. Hyperkoagulační syndrom v těhotenství na podkladě defektu antitrombinu III. Čs gynek 1990; 55 : 657–659.

13. Kvasnička J. Trombofilie a trombotické stavy v klinické praxi. Praha: Grada Publishing 2003 : 13–299.

14. Penka M, Buliková A, Matýšková M et al. Diseminovaná intravaskulární koagulace (DIC). Praha: Grada Avicenum 2003 : 9–231.

15. Ray JG, Chan WS. Deep vein thrombosis during pregnancy and the puerperium: a meta‑analysis of the period of risk and leg of presentation. Obstet Gynecol Surv 1999; 54 : 254–271.

16. Widimský J, Malý J et al. Akutní plicní embolie a žilní trombóza. Praha Triton 2002, 7–303.