Ben-Shlomo I, Azogui G, Prober A, Cozacov C, Zohar S
Department of Obstetrics and Gynecology, Rebecca Sieff Hospital, Safed, Israel.
Obstet Gynecol. 1992 Sep;80(3 Pt 2):495-7.
A 32-year-old multiparous woman had progressive swelling of the right arm at 32 weeks' gestation, accompanied by cyanosis and a preserved radial pulse. Phlebography demonstrated a 5-cm thrombus in the axillary vein. No known etiologic factors were found. Intravenous heparin administration resulted in rapid resolution of the clinical findings. Subcutaneous heparin 10,000 U/day was administered for secondary prophylaxis until cesarean at 39 weeks, during which a full dose was administered without complications. Axillary vein thrombosis during pregnancy may be diagnosed by either phlebography or duplex scanning, and preferably should be treated by heparin. Thrombolytic therapy is justified mainly for life-threatening complications such as pulmonary embolism.
一名32岁的经产妇在妊娠32周时出现右臂进行性肿胀，伴有发绀，桡动脉搏动存在。静脉造影显示腋静脉有一个5厘米的血栓。未发现已知的病因。静脉注射肝素后临床症状迅速缓解。皮下注射肝素10000 U/天进行二级预防，直至39周剖宫产，剖宫产期间给予全剂量肝素，未出现并发症。妊娠期腋静脉血栓形成可通过静脉造影或双功扫描诊断，最好用肝素治疗。溶栓治疗主要适用于肺栓塞等危及生命的并发症。
