Department of Anaesthesia, Royal Gwent Hospital, Cardiff Road, Newport, UK.
Int J Obstet Anesth. 2012 Jul;21(3):253-63. doi: 10.1016/j.ijoa.2012.01.002. Epub 2012 May 29.
The incidence of obesity in pregnancy has increased rapidly in the last decade. Obesity is a risk factor for venous thromboembolism outside of pregnancy and previous studies of maternal death in the UK have identified obesity as a risk factor in pregnancy. As a result the Royal College of Obstetricians and Gynaecologists have targeted obesity as a risk factor in evaluation of the need for thromboprophylaxis in pregnancy. This article highlights the evidence that obesity increases the risk of venous thromboembolism in pregnancy and the puerperium, discusses thromboprophylaxis and appropriate dosing in obese parturients and details the anaesthetic implications of the 2009 Royal College of Obstetricians and Gynaecologists' guidelines. More clinical studies are required to clarify the appropriate dose of low-molecular-weight heparin in an obese parturient.
在过去的十年中，妊娠肥胖的发病率迅速上升。肥胖是妊娠以外静脉血栓栓塞的危险因素，英国以前的孕产妇死亡研究已经确定肥胖是妊娠的危险因素。因此，皇家妇产科医师学院已将肥胖作为评估妊娠期间血栓预防必要性的危险因素之一。本文重点介绍了肥胖增加妊娠和产褥期静脉血栓栓塞风险的证据，讨论了肥胖产妇的血栓预防和适当剂量，并详细介绍了 2009 年皇家妇产科医师学院指南的麻醉影响。需要更多的临床研究来阐明肥胖产妇中低分子量肝素的适当剂量。
