Department of Obstetrics & Gynaecology, NHS Greater Glasgow & Clyde, Scotland.
Department of Haematology, NHS Greater Glasgow & Clyde, Scotland.
Semin Perinatol. 2019 Jun;43(4):222-228. doi: 10.1053/j.semperi.2019.03.008. Epub 2019 Mar 9.
Venous thromboembolism (VTE) is a leading cause of maternal death in the United Kingdom. To address this problem guidance from the Royal College of Obstetricians and Gynaecologists (RCOG) has been developed that recommends the assessment of a woman's risk of thrombosis at specific time-points during pregnancy and postnatally at the time of delivery. The RCOG guidelines provide clinicians with a framework to inform decision-making on the use of thromboprophylaxis and are based on the premise that the higher risk a woman has for VTE, the more likely she is to benefit from prophylaxis - determining her level of risk is based on the number and characteristics of the risk factors that she has. This article will address the pathophysiology of VTE in pregnancy, evidence behind the risk factors for VTE and the use of thromboprophylactic agents. Further, it will reflect on the rationale behind the RCOG guidance.
静脉血栓栓塞症（VTE）是英国孕产妇死亡的主要原因。为了解决这个问题，皇家妇产科医师学院（RCOG）制定了指导方针，建议在怀孕期间和产后分娩时特定时间点评估女性的血栓形成风险。RCOG 指南为临床医生提供了一个框架，用于就使用血栓预防措施做出决策，并基于这样一个前提，即女性患 VTE 的风险越高，她从预防措施中获益的可能性就越大——确定她的风险水平基于她所具有的危险因素的数量和特征。本文将探讨妊娠期 VTE 的病理生理学、VTE 风险因素的证据以及血栓预防药物的使用。此外，它还将反映 RCOG 指南背后的基本原理。
