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抗血小板和抗凝治疗在妊娠中的作用。

Role of Antiplatelets and Anticoagulation Therapies in Pregnancy.

作者信息

Zachariah Krista A, Yuan Su, DeSancho Maria T, Landres Inna V, Singh Harsimran S

机构信息

Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital-Weill Cornell Medicine, New York, NY 10021, USA.

Division of Hematology and Medical Oncology, Department of Medicine, NewYork-Presbyterian Hospital-Weill Cornell Medicine, New York, NY 10021, USA.

出版信息

J Clin Med. 2024 Dec 19;13(24):7757. doi: 10.3390/jcm13247757.

Abstract

Thrombosis is an important cause of morbidity and mortality worldwide. Pregnancy is a hypercoagulable state, and thrombotic complications in pregnancy are a major cause of maternal and fetal morbidity and mortality. Current guidelines support the selective use of aspirin, heparin, and warfarin in pregnant women. The decision to treat with antiplatelets and anticoagulants during pregnancy can be challenging, as these agents have numerous indications and contraindications, potential teratogenicity, and dosing considerations. Their use requires thoughtful discussion between patient and provider that balances therapeutic benefit versus maternal and fetal risks, while accounting for a safe delivery plan. Our aim is to provide a narrative review of the established and emerging indications of antiplatelets and anticoagulants, discuss their appropriate timing of administration, and consider their associated adverse fetal and maternal risks.

摘要

血栓形成是全球发病和死亡的重要原因。妊娠是一种高凝状态,妊娠期间的血栓形成并发症是孕产妇和胎儿发病和死亡的主要原因。当前指南支持对孕妇选择性使用阿司匹林、肝素和华法林。在孕期使用抗血小板药物和抗凝剂进行治疗的决策具有挑战性,因为这些药物有众多适应证和禁忌证、潜在致畸性以及剂量方面的考量。它们的使用需要患者和医疗服务提供者之间进行深入讨论,权衡治疗益处与母婴风险,同时还要考虑安全的分娩计划。我们的目的是对已确立和新出现的抗血小板药物和抗凝剂适应证进行叙述性综述,讨论其合适的给药时机,并考虑其相关的胎儿和母体不良风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d202/11678094/84a25f74d226/jcm-13-07757-g001.jpg

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