von Felten A
Gerinnungslabor, Departement Innere Medizin, Universitätsspital Zürich.
Ther Umsch. 1992 Dec;49(12):837-42.
Women at high risk for thromboembolism deserve prophylactic treatment with heparin in the course of pregnancy. Since activation of the coagulation system is associated with an increase of TAT complexes which may well precede the clinical thrombosis, this parameter was used to determine start as well as dosage of the heparin prophylaxis. Thereby, the increase of TAT complexes during a normal pregnancy without thrombolic events had to be taken in account. 43 pregnancies of 40 patients who had already suffered from thrombotic events before pregnancy or had a positive family history were monitored by this method; in none of them any thromboembolic complication occurred. Duration of treatment and maximal amount of heparin showed wide individual variations and could not be predicted by clinical criteria. However, the total dose of heparin necessary was in many patients far below of what is usually administered, thus reducing the risk of heparin-induced osteoporosis and of local allergic reactions.
血栓栓塞高危女性在孕期值得接受肝素预防性治疗。由于凝血系统激活与TAT复合物增加相关，而这很可能在临床血栓形成之前出现，因此该参数被用于确定肝素预防治疗的起始时间和剂量。由此，必须考虑正常妊娠且无血栓形成事件时TAT复合物的增加情况。通过该方法对40例患者的43次妊娠进行了监测，这些患者在妊娠前已发生血栓形成事件或有阳性家族史；其中无一例发生任何血栓栓塞并发症。治疗持续时间和肝素最大用量存在很大的个体差异，无法通过临床标准预测。然而，许多患者所需肝素的总剂量远低于通常给药剂量，从而降低了肝素诱导的骨质疏松和局部过敏反应的风险。
