Rosenberg Victor A, Lockwood Charles J
Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06520, USA.
Obstet Gynecol Clin North Am. 2007 Sep;34(3):481-500, xi. doi: 10.1016/j.ogc.2007.06.006.
Venous thromboembolism in pregnancy is a clinical emergency that has been associated with significant risk for maternal and fetal morbidity and mortality. The adaptation of the maternal hemostatic system to pregnancy predisposes women to an increased risk of thromboembolism. A timely diagnosis of deep venous thrombosis is crucial because up to 24% of patients with untreated deep venous thrombosis develop a pulmonary embolism. Recent clinical guidelines identify compression venous ultrasound as the best way to diagnose deep venous thrombosis in pregnancy and CT pulmonary angiography as the best way to diagnose pulmonary embolism in pregnancy. Therapy involves supportive care and anticoagulation with unfractionated or low molecular weight heparin, depending on the clinical scenario.
妊娠期静脉血栓栓塞是一种临床急症,与孕产妇和胎儿发病及死亡的重大风险相关。孕产妇止血系统对妊娠的适应性使女性发生血栓栓塞的风险增加。及时诊断深静脉血栓形成至关重要,因为高达24%未经治疗的深静脉血栓形成患者会发生肺栓塞。最近的临床指南将加压静脉超声确定为诊断妊娠期深静脉血栓形成的最佳方法,将CT肺动脉造影确定为诊断妊娠期肺栓塞的最佳方法。治疗包括支持治疗以及根据临床情况使用普通肝素或低分子肝素进行抗凝。