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妊娠和产褥期复发性血栓栓塞。是否需要进行血栓预防?

Recurrent thromboembolism in pregnancy and puerperium. Is there a need for thromboprophylaxis?

作者信息

Tengborn L, Bergqvist D, Mätzsch T, Bergqvist A, Hedner U

机构信息

Department for Coagulation Disorders, University of Lund, General Hospital, Sweden.

出版信息

Am J Obstet Gynecol. 1989 Jan;160(1):90-4. doi: 10.1016/0002-9378(89)90095-1.

DOI:10.1016/0002-9378(89)90095-1
PMID:2912109
Abstract

By sending a questionnaire (response rate 93%) to 321 women with a history of venous thromboembolism and previous coagulation tests, 72 patients were identified who had a total of 87 pregnancies after the thromboembolic episode. The main aim of the study was to analyze the influence of prophylaxis during pregnancy and delivery on the development of further thromboembolic complications. During pregnancy there was no difference in frequency of thromboses between the group given prophylaxis (n = 20) and the group not receiving it (n = 67). At delivery the frequency of thrombosis was 5.3% among the 57 women given prophylaxis and 11.1% among the 30 without prophylaxis, a difference that is not significant. The implication of these findings is discussed both concerning the indications for giving prophylaxis and concerning the problem of designing relevant prophylactic trials.

摘要

通过向321名有静脉血栓栓塞病史且之前进行过凝血检测的女性发送调查问卷(回复率93%),确定了72名患者,她们在血栓栓塞事件后共有87次妊娠。该研究的主要目的是分析妊娠和分娩期间的预防措施对进一步血栓栓塞并发症发生的影响。在妊娠期间,接受预防措施的组(n = 20)和未接受预防措施的组(n = 67)之间血栓形成的频率没有差异。在分娩时,57名接受预防措施的女性中血栓形成的频率为5.3%,30名未接受预防措施的女性中血栓形成的频率为11.1%,差异不显著。讨论了这些发现对于预防措施的指征以及设计相关预防性试验问题的意义。

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Am J Obstet Gynecol. 1989 Jan;160(1):90-4. doi: 10.1016/0002-9378(89)90095-1.
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VTE, thrombophilia, antithrombotic therapy, and pregnancy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.静脉血栓栓塞症、血栓形成倾向、抗血栓治疗与妊娠:《抗血栓治疗与血栓预防,第 9 版:美国胸科医师学会循证临床实践指南》。
Chest. 2012 Feb;141(2 Suppl):e691S-e736S. doi: 10.1378/chest.11-2300.
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Wien Klin Wochenschr. 2003 Aug 14;115(13-14):482-4. doi: 10.1007/BF03041032.