易栓症与妊娠、分娩及产褥期静脉血栓栓塞的风险

Thrombophilia and the risk for venous thromboembolism during pregnancy, delivery, and puerperium.

作者信息

Nelson Scott M, Greer Ian A

机构信息

Reproductive and Maternal Medicine, Division of Developmental Medicine, University of Glasgow, Glasgow Royal Infirmary, 10 Alexandra Parade, Glasgow, G31 ER, Scotland, United Kingdom.

出版信息

Obstet Gynecol Clin North Am. 2006 Sep;33(3):413-27. doi: 10.1016/j.ogc.2006.05.009.

DOI:10.1016/j.ogc.2006.05.009

PMID:16962918

Abstract

The main inherited thrombophilias (antithrombin deficiency, protein C and S deficiency, FVL, the prothrombin gene variant, and MTHFR C677T homozygotes) have a combined prevalence in Western European populations of 15% to 20%. One or more of these inherited thrombophilias is usually found in approximately 50% of women who have a personal history of VTE. Obstetricians must therefore be aware of the interaction between thrombophilias and the procoagulant state of pregnancy and should have an understanding of additional risk factors that may act synergistically with thrombophilias to induce VTE. Such knowledge combined with the appropriate use of thromboprophylaxis and treatment in women who have objectively confirmed VTE continue to improve maternal and perinatal outcomes.

摘要

主要的遗传性易栓症（抗凝血酶缺乏症、蛋白C和S缺乏症、FVL、凝血酶原基因变异体以及MTHFR C677T纯合子）在西欧人群中的综合患病率为15%至20%。在有VTE个人史的女性中，通常约50%会发现一种或多种此类遗传性易栓症。因此，产科医生必须了解易栓症与妊娠促凝状态之间的相互作用，并且应该了解可能与易栓症协同作用诱发VTE的其他风险因素。这些知识，再加上对客观确诊为VTE的女性进行适当的血栓预防和治疗，持续改善孕产妇和围产儿结局。