Mehraein S, Ortwein H, Busch M, Weih M, Einhäupl K, Masuhr F
Department of Neurology, Charité Medical School, Humboldt-Universität, Berlin, Germany.
J Neurol Neurosurg Psychiatry. 2003 Jun;74(6):814-6. doi: 10.1136/jnnp.74.6.814.
To assess the risk of recurrence of cerebral venous and sinus thrombosis (CVST) during subsequent pregnancy and puerperium in women with previous cerebral venous occlusive disease.
The authors retrospectively studied the relapse rate of CVST and the incidence of extracerebral venous thrombosis during subsequent pregnancies in 39 women (from 125 patients with CVST) who suffered a CVST at childbearing age.
Mean follow up was 10.25 years (range 1 to 20). Twenty two pregnancies and 19 births were observed in 14 women without evidence of either recurrence of CVST or extracerebral venous thrombosis. One pregnancy occurred during oral anticoagulation and was interrupted and two pregnancies ended with spontaneous abortions. Low dose heparin had been given during five pregnancies.
The risk of recurrence for CVST during pregnancy seems to be low and these data do not justify a negative advice on pregnancy in women with previous CVST. Further studies are needed to evaluate the need for a prophylactic anticoagulation during pregnancy and puerperium.
评估既往有脑静脉闭塞性疾病的女性在随后妊娠及产褥期发生脑静脉和窦血栓形成(CVST)复发的风险。
作者回顾性研究了39名(来自125例CVST患者)育龄期发生CVST的女性在随后妊娠期间CVST的复发率及脑外静脉血栓形成的发生率。
平均随访10.25年(范围1至20年)。14名女性中有22次妊娠和19次分娩,未发现CVST复发或脑外静脉血栓形成的证据。1次妊娠发生在口服抗凝治疗期间并中断,2次妊娠以自然流产告终。5次妊娠期间给予了低剂量肝素。
妊娠期间CVST复发的风险似乎较低,这些数据并不支持对既往有CVST的女性给出不宜妊娠的负面建议。需要进一步研究以评估妊娠及产褥期预防性抗凝治疗的必要性。