de Oliveira André Luiz Malavasi Longo, Marques Marcos Arêas
Centro de Referência da Saúde da Mulher do Estado de São Paulo, São Paulo, SP, Brasil.
Universidade do Estado do Rio de Janeiro - UERJ, Hospital Universitário Pedro Ernesto - HUPE, Angiologia, Rio de Janeiro, RJ, Brasil.
J Vasc Bras. 2016 Oct-Dec;15(4):293-301. doi: 10.1590/1677-5449.006616.
Venous thromboembolism is a major cause of obstetric morbidity and mortality. During pregnancy, the risk of occurrence increases between five and ten times when compared to women of the same age who are not pregnant. Compounding this is the fact that pregnant women present certain characteristics that make diagnosis more difficult using clinical signs (high frequency of pain and swelling in the lower limbs), echographic examination (lower sensitivity and specificity for diagnosis of iliac vein thrombosis as pregnancy progresses), and laboratory findings (D-dimer levels progressively increase throughout pregnancy). Conducting careful stratification of women’s venous thromboembolism risk before pregnancy could reduce the incidence of this disease, which is frequent and difficult to diagnose during pregnancy, and of its complications.
静脉血栓栓塞是产科发病和死亡的主要原因。在怀孕期间,与未怀孕的同龄女性相比,发病风险增加5至10倍。此外,孕妇具有某些特征,这使得使用临床体征(下肢疼痛和肿胀的高发生率)、超声检查(随着妊娠进展,对髂静脉血栓形成诊断的敏感性和特异性降低)和实验室检查结果(整个孕期D-二聚体水平逐渐升高)进行诊断更加困难。在怀孕前对女性静脉血栓栓塞风险进行仔细分层,可以降低这种在孕期常见且难以诊断的疾病及其并发症的发生率。