Ohwada Tetsuro, Kamiyama Yoichiro, Watanabe Koji, Kamiyama Tomonari, Maeda Tsuyoshi, Mori Yu
Department of Anesthesiology and Pain Medicine, Juntendo University Urayasu Hospital, Urayasu-shi, Chiba, Japan.
J Obstet Gynaecol Res. 2019 Oct;45(10):2100-2104. doi: 10.1111/jog.14087. Epub 2019 Jul 31.
Buerger disease is a chronic inflammatory disease that involves blood clot formation in the medium and small arteries, resulting in thrombophlebitis. It is usually observed in middle-aged men who smoke and is very rare in young women. Previous reports have indicated that Buerger disease worsens during pregnancy due to hypercoagulability associated with pregnancy, and newborns' birth weights were often lower than normal. This report describes a young woman with Buerger disease who experienced two pregnancies and deliveries. During the 1st pregnancy, d-dimer and soluble fibrin levels slightly increased, but no treatment was needed. However, during the 2nd pregnancy, d-dimer and soluble fibrin levels abruptly increased at 20 weeks of pregnancy, and heparin was administered subcutaneously. Four days after heparin administration, d-dimer and soluble fibrin levels decreased to normal pregnancy levels. d-dimer and soluble fibrin measurements were useful for evaluating the coagulation tendencies of this pregnant woman with Buerger disease.
血栓闭塞性脉管炎是一种慢性炎症性疾病，涉及中小动脉血栓形成，导致血栓性静脉炎。它通常在吸烟的中年男性中观察到，在年轻女性中非常罕见。先前的报告表明，由于与妊娠相关的高凝状态，血栓闭塞性脉管炎在妊娠期间会恶化，新生儿出生体重往往低于正常水平。本报告描述了一名患有血栓闭塞性脉管炎的年轻女性经历了两次怀孕和分娩。在第一次怀孕期间，D-二聚体和可溶性纤维蛋白水平略有升高，但无需治疗。然而，在第二次怀孕期间，怀孕20周时D-二聚体和可溶性纤维蛋白水平突然升高，并皮下注射了肝素。肝素注射4天后，D-二聚体和可溶性纤维蛋白水平降至正常妊娠水平。D-二聚体和可溶性纤维蛋白测量对于评估这名患有血栓闭塞性脉管炎的孕妇的凝血倾向很有用。
