Hara Nobuhiro, Miyamoto Takamichi, Yamaguchi Junji, Iwai Takamasa, Hijikata Sadahiro, Watanabe Keita, Sagawa Yuichiro, Masuda Ryo, Miyazaki Ryoichi, Miwa Naoyuki, Sekigawa Masahiro, Yamaguchi Tetsuo, Nagata Yasutoshi, Nozato Toshihiro, Kobayashi Orie, Umezawa Satoshi, Obayashi Toru
Department of Cardiology, Japanese Red Cross Musashino Hospital, Tokyo, Japan.
Department of General Medicine, Japanese Red Cross Musashino Hospital, Tokyo, Japan.
Ann Vasc Dis. 2018 Mar 25;11(1):106-111. doi: 10.3400/avd.oa.17-00100.
: Although deep vein thrombosis (DVT) followed by pulmonary thromboembolism (PE) is a critical complication during pregnancy, there have been few reports about its intrapartum management. We evaluated intrapartum management by using a temporary inferior vena cava filter (IVCF) in pregnant women with PE/DVT. : Eleven women with PE/DVT during pregnancy between January 2004 and December 2016 were included. The patients were hospitalized for intravenous unfractionated heparin infusion after acute PE/DVT onset. Seven patients were discharged and continued treatment with subcutaneous injection of heparin at the outpatient unit. IVCF was implanted 1-3 days before delivery in 10 patients. Anticoagulant therapy was discontinued 6-12 h before delivery. We retrospectively analyzed rates of maternal or perinatal death, and recurrence of symptomatic PE/DVT. : One patient was diagnosed as having PE/DVT and 10 had DVT alone. One patient suffered hemorrhagic shock during delivery; however, maternal or perinatal death and recurrence of symptomatic PE/DVT did not occur in any patient. : Maternal or perinatal death and recurrence of symptomatic PE/DVT was not seen in women diagnosed as having PE/DVT during pregnancy and treated with anticoagulant therapy and IVCF.
虽然深静脉血栓形成(DVT)继以肺血栓栓塞症(PE)是妊娠期的一种严重并发症,但关于其产时管理的报道却很少。我们评估了在患有PE/DVT的孕妇中使用临时下腔静脉滤器(IVCF)进行产时管理的情况。
纳入了2004年1月至2016年12月期间孕期发生PE/DVT的11名女性。急性PE/DVT发作后,患者住院接受静脉注射普通肝素治疗。7名患者出院,在门诊继续皮下注射肝素治疗。10名患者在分娩前1 - 3天植入IVCF。分娩前6 - 12小时停用抗凝治疗。我们回顾性分析了孕产妇或围产儿死亡率以及有症状的PE/DVT复发率。
1名患者被诊断为患有PE/DVT,10名仅患有DVT。1名患者在分娩期间发生失血性休克;然而,没有任何患者发生孕产妇或围产儿死亡以及有症状的PE/DVT复发。
在孕期被诊断为患有PE/DVT并接受抗凝治疗和IVCF治疗的女性中,未观察到孕产妇或围产儿死亡以及有症状的PE/DVT复发。