Treatment of Acute Venous Thromboses and Pulmonary Embolism during Pregnancy
International Journal of Biomedicine. 2018;8(3):244-246.
Originally published September 15, 2018
The aim of the study was to improve the results of the treatment of acute ascending varicothrombosis, deep vein thrombosis (DVT) and pulmonary embolism (PE) during pregnancy and the postpartum period. The study included 22 pregnant women aged between 20 and 41 years in different periods of pregnancy and in the early postpartum period, with acute thrombosis of deep and superficial veins of the lower extremities complicated by PE. All of the generally accepted methods for treatment of DVT, varicothrombophlebitis and PE were applied. In 16(72.8%) pregnant women with DVT of the lower limbs, in the absence of free-floating thrombus, conservative treatment was effective; an IVC filter was placed in only 1 patient. Combined phlebectomies of the great saphenous vein with thrombosed tributaries were performed in 4(18.8%) patients with ascending varicothrombosis in the early postpartum period, resulting in early recovery and discharge from the hospital. Thrombolytic therapy in the patient with massive PE in the first trimester of pregnancy saved the life of the mother and child.
1. Aleksandrov BD. Investigation of the hemostatic system and the rationale for antithrombotic therapy with fraxiparine in pregnant women with gestosis Abstract of PhD Thesis. Moscow; 2000.[In Russian].
2. Vardanyan AV, Badanyan AL, Mumladze RB, Patrushev LI, Rojtman EV, Dolidze DD, Tokarev KY. Idiopathic deep vein thrombosis: modern approaches to diagnosis and treatment. Flebologiya. 2014;8(2):16-20. [Article in Russian].
3. Balovneva EV, Avchenko MT. Thrombosis as complication of pregnancy and labor. Prevention of thromboembolic complications. Studencheskii. 2017;5(5). Available from: https://sibac.info/journal/student/5/75816 [Article in Russian].
4. Russian clinical recommendations "Diagnosis, treatment and prevention of venous thromboembolic complications". Edited by A.I. Kirienko. Moscow; 2015. [In Russian].
5. Prevention of venous thromboembolic complications in obstetrics and gynecology. Clinical recommendations. Akusherstvo I Ginekologiya. 2014;(10) (Suppl):1-18.[In Russian].
6. VTE, thrombophilia, antithrombotic therapy, and pregnancy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e 691S-736S. doi: 10.1378/chest.11-2300. PubMed
7. Simcox LE, Ormesher L, Tower C, Greer IA. Pulmonary thrombo-embolism in pregnancy: diagnosis and management. Breathe (Sheff). 2015 Dec;11(4):282-9. doi: 10.1183/20734735.008815. PubMed
8. Krylov AYu, Shulutko AM, Osmanov EG, Khmyrova SE, Gogokhiya TR, Lobanova MV. [Clinico-diagnostic algorithm in the treatment of patients with acute varicothrombophlebitis of the lower extremities]. Ross Med Zhurnal. 2010;(2):20-25. [Article in Russian].
9. Fokin AA, Prikhodko VV, Medvedev AP, Vladimirsky VV. Surgical prophylaxis and treatment of pulmonary embolism. Chelyabinsk; 2010. [In Russian].
10. Konstantinides SV, Torbicki A, Agnelli G, Danchin N, Fitzmaurice D, Galiè N, et al.; Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J. 2014 Nov 14;35(43):3033-69, 3069a-3069k. doi: 10.1093/eurheartj/ehu283. PubMed
Received June 28, 2018.
Accepted July 13, 2018.
©2018 International Medical Research and Development Corporation.