Dindinger Rebeccah, Mulla Bethany M, Stucky Christopher
J Obstet Gynecol Neonatal Nurs. 2023 Nov;52(6):501-508. doi: 10.1016/j.jogn.2023.07.003. Epub 2023 Aug 16.
Women are at increased risk of thromboembolism during pregnancy because of hypercoagulability associated with pregnancy. Heparin-induced thrombocytopenia (HIT) is an uncommon complication of heparin therapy, and patients with histories of HIT cannot receive any heparin-derived medications. Limited data exist regarding the clinical management of pregnant women with histories of HIT. Umbilical artery thrombosis (UAT) is a rare fetal complication with significant fetal morbidity and mortality. Using the CARE guidelines, we report a case of a woman previously diagnosed with HIT who received long-term anticoagulation therapy and whose fetus developed UAT at 27 weeks gestation. The purpose of this case report is to share our successful expectant management plan of care, which centered on the woman, involved multidisciplinary collaboration, and led to a term cesarean birth.
由于与妊娠相关的高凝状态，女性在孕期发生血栓栓塞的风险增加。肝素诱导的血小板减少症（HIT）是肝素治疗的一种罕见并发症，有HIT病史的患者不能使用任何肝素衍生药物。关于有HIT病史的孕妇的临床管理，现有数据有限。脐动脉血栓形成（UAT）是一种罕见的胎儿并发症，具有显著的胎儿发病率和死亡率。按照CARE指南，我们报告一例先前诊断为HIT的女性病例，该女性接受了长期抗凝治疗，其胎儿在妊娠27周时发生了UAT。本病例报告的目的是分享我们成功的期待管理护理计划，该计划以患者为中心，涉及多学科协作，并最终实现足月剖宫产分娩。
