脑静脉血栓形成后妊娠的安全性：国际脑静脉和硬脑膜窦血栓形成研究（ISCVT）-2妊娠研究结果
Safety of Pregnancy After Cerebral Venous Thrombosis: Results of the ISCVT (International Study on Cerebral Vein and Dural Sinus Thrombosis)-2 PREGNANCY Study.
作者信息
Aguiar de Sousa Diana, Canhão Patrícia, Crassard Isabelle, Coutinho Jonathan, Arauz Antonio, Conforto Adriana, Béjot Yannick, Giroud Maurice, Ferro José M
机构信息
From the Department of Neurology, Hospital de Santa Maria, University of Lisbon, Portugal (D.A.d.S., P.C., J.M.F.); Instituto de Medicina Molecular, Lisbon, Portugal (D.A.d.S., P.C., J.M.F.); Department of Neurology, Hôpital Lariboisière, Paris, France (I.C.); Department of Neurology, Academic Medical Centre, Amsterdam, the Netherlands (J.C.); Department of Neurology, Instituto Nacional de Neurologia y Neurocirurgia Manuel Velasco Suárez, Mexico City, Mexico (A.A.); Department of Neurology, Hospital das Clínicas, São Paulo University, Brazil (A.C.); and Stroke Unit, University Hospital and Medical School of Dijon, France (Y.B., M.G.).
出版信息
Stroke. 2017 Nov;48(11):3130-3133. doi: 10.1161/STROKEAHA.117.018829. Epub 2017 Oct 3.
BACKGROUND AND PURPOSE
Pregnancy is associated with increased risk of venous thrombotic events, including cerebral venous thrombosis. We aimed to study the complications and outcome of subsequent pregnancies in women with previous cerebral venous thrombosis.
METHODS
Follow-up study of women with acute cerebral venous thrombosis at childbearing age included in a previously described cohort (International Study of Cerebral Vein and Dural Sinus Thrombosis). Patients were interviewed by local neurologists to assess rate of venous thrombotic events, pregnancy outcomes, and antithrombotic prophylaxis during subsequent pregnancies.
RESULTS
A total of 119 women were included, with a median follow-up of 14 years. Eighty-two new pregnancies occurred in 47 women. In 83% (68 of 82), some form of antithrombotic prophylaxis was given during at least 1 trimester of pregnancy or puerperium. Venous thrombotic events occurred in 3 pregnancies, including 1 recurrent cerebral venous thrombosis. Two of the 3 women were on prophylactic low-molecular-weight heparin at the time of the event. Outcomes of pregnancies were 51 full-term newborns, 9 preterm births, 2 stillbirths, and 20 abortions (14 spontaneous).
CONCLUSIONS
In women with prior cerebral venous thrombosis, recurrent venous thrombotic events during subsequent pregnancies are infrequent.
背景与目的
妊娠与静脉血栓形成事件风险增加相关，包括脑静脉血栓形成。我们旨在研究既往有脑静脉血栓形成的女性后续妊娠的并发症及结局。
方法
对先前描述队列（脑静脉和硬脑膜窦血栓形成国际研究）中纳入的育龄期急性脑静脉血栓形成女性进行随访研究。由当地神经科医生对患者进行访谈，以评估后续妊娠期间静脉血栓形成事件的发生率、妊娠结局及抗血栓预防情况。
结果
共纳入119名女性，中位随访时间为14年。47名女性发生了82次新的妊娠。83%（82例中的68例）在妊娠或产褥期至少1个孕期接受了某种形式的抗血栓预防。3次妊娠发生了静脉血栓形成事件，包括1例复发性脑静脉血栓形成。事件发生时，3名女性中有2名正在接受预防性低分子肝素治疗。妊娠结局为51例足月新生儿、9例早产、2例死产和20例流产（14例自然流产）。
结论
既往有脑静脉血栓形成的女性，后续妊娠期间复发性静脉血栓形成事件并不常见。
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