Speciality Fetal Maternal Medicine
Library of the School of Health Sciences

2024-06-18

2024

Karakasidou Maria

Ελευθεριάδης Μακάριος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Πανουλής Κωνσταντίνος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Σωτηριάδης Αλέξανδρος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΑΠΘ

Kύηση και θρόμβωση μεγάλων αγγείων - βιβλιογραφική ανασκόπηση

Greek

Pregnancy and large vessels thrombosis-literature review

Women during pregnancy and postpartum period are in high risk of thromboembolism. Thrombosis is one of the leading etiologies of maternal mortality.The risk of venous thrombosis increases by 6 times in pregnancy and up to 22 times in puerperium compared to non-pregnant women. 75 to 80% of cases of thrombosis in pregnancy are of venous origin, while 20-25% are arterial. The main reason for the increased risk is the hypercoagulability that occurs during pregnancy to protect the pregnant woman from bleeding during childbirth and in the event of a miscarriage. While the leading cause of maternal mortality in developing countries is bleeding, in developed countries, where deaths from bleeding have decreased due to all the preventive measures taken, the leading cause of maternal mortality is thromboembolic disease. Both genetic and acquired factors can further increase pre-existing risk. Maternal effects of thrombosis include permanent vascular damage, disability, and death. In addition to the effects on maternal health, pregnant women who experience thrombotic episodes in pregnancy have an increased risk of poor perinatal outcome. Knowing the absolute risk of thrombosis in pregnant women is critical in identifying women who will benefit from thromboprophylaxis.
Deep vein thrombosis of the lower extremities is the most common with pulmonary embolism. Vascular strokes are divided into ischemic, hemorrhagic and from thrombosis of the cerebral vascular sinuses. But the occlusion of the mesenteric vessels is a quite serious medical condition with an increased risk for the mother and the fetus.
Therapeutic interventions in thromboembolic disease are anticoagulant therapy using classic heparin or low molecular weight heparin which is more widespread. Also warfarin therapy has a key role in puerperium due to its embryotoxicity if used during pregnancy. In several cases, endovascular thrombolysis, embolectomy and the placement of a filter in the inferior vena cava are used in cases with an increased risk of bleeding with the previous interventions.

Health Sciences

Pregnancy, Thromboembolism, Anticoagulant therapy, Puerperium, Stroke

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https://pergamos.lib.uoa.gr/uoa/dl/object/3401138