妊娠期静脉血栓栓塞的评价与治疗方法探讨。

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Accounts of Chemical Research Pub Date : 2021-11-01 Epub Date: 2021-09-24 DOI:10.1055/s-0041-1736188
Benjamin Brenner, Elvira Grandone, Alexander Makatsariya, Jamilya Khizroeva, Victoria Bitsadze, Maria Tretyakova
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引用次数: 4

摘要

妊娠期血栓形成是孕产妇和胎儿发病和死亡的主要原因。妊娠期间静脉血栓栓塞(VTE)的风险分层是复杂的。在孕妇中观察到的高凝性可以减少分娩时的出血,但可能导致血栓形成,特别是在存在其他血栓形成危险因素(如抗磷脂抗体或遗传性血栓性缺陷)的情况下。大数据集的可用性允许识别额外的独立风险因素,包括辅助生殖技术(ARTs)、子宫内膜异位症和复发性妊娠丢失。关于孕妇与COVID-19相关的静脉血栓栓塞风险的数据非常有限,但表明受感染的孕妇发生静脉血栓栓塞的风险增加。目前关于预防和治疗妊娠静脉血栓栓塞的指南是基于现有的(尽管有限的)数据和主要是目前的专家意见。低分子肝素(LMWHs)是妊娠期间抗凝治疗的主要药物。妊娠期静脉血栓栓塞治疗中低分子肝素的给药应基于个性化的方法,并考虑到基于体重的调整方案。在妊娠期间,由于生理变化,静脉血栓栓塞高风险妇女,监测抗xa活性,以确保足够的低分子肝素剂量。对于急性静脉血栓栓塞孕妇的治疗时间,指南建议抗凝治疗应至少持续产后6周,总治疗时间至少为3个月。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Approach to the Evaluation and Treatment of Venous Thromboembolism in Pregnancy.

Thrombosis in pregnancy is a major cause of maternal and fetal morbidity and mortality. Risk stratification of venous thromboembolism (VTE) during pregnancy is complex. The hypercoagulability observed in pregnant women can reduce bleeding during childbirth, but may cause thrombosis especially in the presence of additional prothrombotic risk factors such as antiphospholipid antibodies or genetic thrombophilic defects. The availability of large datasets allows for the identification of additional independent risk factors, including assisted reproductive technologies (ARTs), endometriosis, and recurrent pregnancy loss. Data on the risk of VTE linked to COVID-19 in pregnant women are very limited, but suggest that infected pregnant women have an increased risk of VTE. Current guidelines on the prevention and treatment of VTE in pregnancy are based on available, albeit limited, data and mainly present expert opinion. Low-molecular-weight heparins (LMWHs) are the mainstay of anticoagulation to be employed during pregnancy. Administration of LMWH for VTE treatment in pregnancy should be based on the personalized approach, taking into account a weight-based adjusted scheme. During gestation, due to physiological changes, in women at high risk of VTE, monitoring of anti-Xa activity is performed to ensure adequate LMWH dosing. As for the treatment duration for pregnant women with acute VTE, guidelines suggest that anticoagulation should be continued for at least 6 weeks postpartum for a minimum total duration of therapy of 3 months.

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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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