Gibson P S, Rosene-Montella K
Division of Obstetric and Consultative Medicine, Department of Medicine, Women and Infants' Hospital of Rhode Island and Brown University School of Medicine, Providence 02095, USA.
Best Pract Res Clin Obstet Gynaecol. 2001 Dec;15(6):847-61. doi: 10.1053/beog.2001.0233.
Pregnancy is a period of heightened coagulability and enhanced risk for thrombotic complications. Thromboembolism is the leading cause of maternal mortality. Anticoagulants are very useful during pregnancy for the acute treatment of venous thromboembolism and for the prevention of recurrent venous thromboembolism. They may also be beneficial in patients with thrombophilias, particularly among women who have experienced adverse pregnancy outcomes such as recurrent pregnancy loss. Anticoagulation is essential but problematic in the management of pregnant women with mechanical heart valve prostheses. When utilizing these medications among pregnant women the potential benefits must be balanced against the possibility of maternal haemorrhagic complications, adverse effects on the pregnancy or toxic effects on the fetus. This chapter summarizes current knowledge about the anticoagulant agents, their potential toxicities and their therapeutic role in pregnant women with various indications for anticoagulant therapy.
孕期处于高凝状态，发生血栓并发症的风险增加。血栓栓塞是孕产妇死亡的主要原因。抗凝剂在孕期对于静脉血栓栓塞的急性治疗以及预防复发性静脉血栓栓塞非常有用。它们对于患有易栓症的患者可能也有益处，尤其是在经历过不良妊娠结局（如复发性流产）的女性中。在患有机械心脏瓣膜假体的孕妇管理中，抗凝至关重要但存在问题。在孕妇中使用这些药物时，必须权衡潜在益处与孕产妇出血并发症、对妊娠的不良影响或对胎儿的毒性作用的可能性。本章总结了关于抗凝剂、其潜在毒性以及它们在有各种抗凝治疗指征的孕妇中的治疗作用的当前知识。
