Heilmann L, Hojnacki B, Fischer W M
Abt. Gynäkologie und Geburtshilfe, Stadtkrankenhaus, Rüsselsheim.
Z Geburtshilfe Perinatol. 1990 Nov-Dec;194(6):275-8.
Twenty-two cases of acute venous thrombosis in pregnancy (0.64%) were studied. Concomitant pulmonary embolism was documented in 0.23%. Prophylactic heparinization was performed in 32 gravidae. In the acute thrombosis group therapy was instituted in the 26th week, and in the prophylaxis group in the 20th week of pregnancy. Recurrent thromboses after cesarean section occurred in 4.5% of the patients with acute venous thrombosis and in 5.6% of those in the prophylaxis group. Reduced red blood cell deformability, low antithrombin III and high leukocyte count were identified as risk factors. Heparinization did not prevent increased red blood cell aggregation and plasma viscosity at birth. Rheologic factors played only a secondary role in the prophylaxis group. Prophylactic heparinization in pregnancy is currently the only means of reducing the thrombosis recurrence rate in patients with a history of thromboembolism.
对22例妊娠期急性静脉血栓形成患者（占0.64%）进行了研究。记录到伴有肺栓塞的病例占0.23%。32名孕妇接受了预防性肝素治疗。急性血栓形成组在妊娠第26周开始治疗，预防组在妊娠第20周开始治疗。剖宫产术后，急性静脉血栓形成患者中有4.5%复发血栓，预防组中有5.6%复发血栓。红细胞变形性降低、抗凝血酶III水平低和白细胞计数高被确定为危险因素。肝素治疗并不能防止出生时红细胞聚集增加和血浆粘度升高。在预防组中，流变学因素仅起次要作用。目前，妊娠期预防性肝素治疗是降低有血栓栓塞病史患者血栓复发率的唯一方法。
