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脑静脉血栓形成:以妊娠、激素治疗的使用及辅助生殖技术为重点的管理策略

Cerebral vein thrombosis: management tactics with a focus on pregnancy, the use of hormone therapy and assisted reproductive technologies.

作者信息

Akinshina Svetlana, Bitsadze Viktoria, Khizroeva Jamilya, Tretyakova Maria, Grigoreva Kristina, Gashimova Nilufar, Vorobev Alexander, Zubenko Vladislav, Makatsariya Nataliya, Valikhanova Lala, Kapanadze Daredzhan, Zainulina Marina, Solopova Alina, Mashkova Tamara, Yagubova Fidan, Tsibizova Valentina, Gris Jean-Christophe, Elalamy Ismail, Gerotziafas Grigoris, Makatsariya Alexander

机构信息

Department of Obstetrics, Gynecology and Perinatal Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.

Stavropol Regional Clinical Perinatal Center, Stavropol, Russia.

出版信息

J Matern Fetal Neonatal Med. 2025 Dec;38(1):2447349. doi: 10.1080/14767058.2024.2447349. Epub 2025 Jan 5.

DOI:10.1080/14767058.2024.2447349
PMID:
39757006
Abstract

Cerebral vein thrombosis is a rare, life-threatening condition that has now become more commonly diagnosed due to advancements in imaging techniques. Our purpose is to improve understanding of pathogenesis, diagnosis and pregnancy and IVF management in patients with a history of cerebral thrombosis. We present an overview of the modern tactics of anticoagulant therapy for cerebral thrombosis with a focus on pregnancy, the use of hormone therapy, and assisted reproductive technologies. The most common risk factors for cerebral vein thrombosis are pregnancy, the postpartum period, and the use of oral contraceptives, which explains the high incidence of this pathology in women. The development of cerebral thrombosis is a vivid example of the interaction and synergetic effects of persistent factors that cause an increased risk of thrombotic complications, which include thrombophilia and acquired risk factors. Despite the possible risks, pregnancy after previously suffered cerebral thrombosis is not contraindicated provided adequate anticoagulant therapy. The most common provoking factors for the development of cerebral thrombosis in women are pregnancy and the use of estrogen-containing drugs. The issue of thromboprophylaxis during pregnancy, when using ART methods and the possibility of using hormonal therapy after cerebral vein thrombosis requires further study.

摘要

脑静脉血栓形成是一种罕见的、危及生命的疾病,由于成像技术的进步,现在已更常被诊断出来。我们的目的是提高对有脑血栓病史患者的发病机制、诊断以及妊娠和体外受精管理的认识。我们概述了脑血栓抗凝治疗的现代策略,重点关注妊娠、激素治疗的使用以及辅助生殖技术。脑静脉血栓形成最常见的危险因素是妊娠、产后时期和口服避孕药的使用,这解释了这种病理在女性中的高发病率。脑血栓的发生是导致血栓形成并发症风险增加的持续因素相互作用和协同效应的生动例子,这些因素包括血栓形成倾向和获得性危险因素。尽管存在潜在风险,但在进行充分抗凝治疗的情况下,既往患过脑血栓后妊娠并非禁忌。女性发生脑血栓最常见的诱发因素是妊娠和使用含雌激素药物。在使用辅助生殖技术时妊娠期间的血栓预防问题以及脑静脉血栓形成后使用激素治疗的可能性需要进一步研究。

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Cerebral vein thrombosis: management tactics with a focus on pregnancy, the use of hormone therapy and assisted reproductive technologies.脑静脉血栓形成:以妊娠、激素治疗的使用及辅助生殖技术为重点的管理策略
J Matern Fetal Neonatal Med. 2025 Dec;38(1):2447349. doi: 10.1080/14767058.2024.2447349. Epub 2025 Jan 5.
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