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Treatment of Venous Thromboembolism during Pregnancy and Puerperium
Puni tekst: pdf (59 KB),
Str. 25 - 29
Venous thromboembolism (VTE) occurs infrequently but remains the leading cause of pregnancy- and puerperium-related mortality in industrialized countries. In pregnant women, the risk of VTE is about 4- to 5-fold that in non-pregnant women. The pathogenesis of VTE is associated with venous stasis, endothelial damage to pelvic veins at delivery, and procoagulant changes that occur during pregnancy and puerperium. The most common risk factors for VTE during pregnancy and puerperium are previous thrombotic event(s), thrombophilia, age over 35, obesity and operative delivery. Deep venous thrombosis in pregnancy and puerperium is usually left-sided (85% versus 55% in non-pregnant patients) and iliofemoral (72% in pregnancy versus 9% in non-pregnant patients). Low-molecular weight heparins (LMWHs) are the drugs of choice for the treatment of VTE during pregnancy and puerperium, as they are effective and have substantially fewer side effects such as heparin-induced thrombocytopenia, bleeding and osteoporosis as well as more reliable antithrombotic activity compared with unfractionated heparin.
Venous thrombosis -etiology; Pregnancy - complications; Venous thrombosis - therapy; Risk factors
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