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https://repository.monashhealth.org/monashhealthjspui/handle/1/30327| Title: | Critical illness in obstetric patients: Venous thromboembolism in pregnancy. | Authors: | Chunilal S.D.;Chan W.S. | Institution: | (Chunilal) Department of Haematology, Ginger Bread House, North Shore Hospital, Takapuna, Auckland, New Zealand (Chunilal) Department of Clinical Haematology, Monash Medical Centre, Clayton, Melbourne, VIC, Australia (Chan) Department of Medicine, University of Toronto, Toronto, ON, Canada | Issue Date: | 6-Oct-2012 | Copyright year: | 2011 | Publisher: | Bentham Science Publishers B.V. (P.O. Box 294, Bussum 1400 AG, Netherlands) | Place of publication: | Netherlands | Publication information: | Current Women's Health Reviews. 7 (2) (pp 189-202), 2011. Date of Publication: June 2011. | Abstract: | During pregnancy, the risk of venous thromboembolism (VTE) increases 2-5 fold and pulmonary embolism (PE) remains a leading cause of maternal mortality in developed countries. For pregnant women with suspected deep vein thrombosis (DVT) or PE, the use of serial compression leg ultrasound (CUS) should be considered to exclude DVT whereas a normal ventilation perfusion lung scan likely excludes PE. A computer tomographic pulmonary angiogram (CTPA) could assist in ruling out PE in women who present with an abnormal chest radiograph. Low molecular weight heparins (LMWH) are the agents of choice for treatment and thromboprophylaxis of pregnant patients with VTE but appropriate dosing changes throughout pregnancy remain uncertain. Women with previously unprovoked VTE and those in whom VTE are provoked by previous pregnancies or use of oral contraceptive are at highest risk of VTE recurrence during pregnancy, and should be offered antepartum and postpartum thromboprophylaxis. On the other hand, women with prior VTE related to a transient risk factor would benefit from postpartum thromboprophylaxis. More research is needed to identify the absolute risk of VTE during pregnancy associated with more prevalent risk factors such as maternal age, obesity, and mode of delivery. © 2011 Bentham Science Publishers Ltd. | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.2174/157340411795445749 | ISSN: | 1573-4048 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/30327 | Type: | Article | Subjects: | *deep vein thrombosis/di [Diagnosis] *deep vein thrombosis/dt [Drug Therapy] *deep vein thrombosis/ep [Epidemiology] *deep vein thrombosis/pc [Prevention] *deep vein thrombosis/th [Therapy] deep vein thrombosis/dt [Drug Therapy] delivery diabetes mellitus disease association disease severity Doppler flowmetry dosage schedule comparison drug substitution drug withdrawal embryopathy/si [Side Effect] fertilization in vitro fetal hemorrhage/si [Side Effect] fetus outcome fibrinolysis high risk patient high risk pregnancy human hypertension immobilization infection infection complication injection site reaction/si [Side Effect] labor low drug dose lung angiography lung embolism/di [Diagnosis] lung embolism/dt [Drug Therapy] lung scintiscanning lung ventilation perfusion ratio maternal mortality mother neurologic disease/si [Side Effect] nuclear magnetic resonance imaging obesity obstetric patient obstetrics oral contraception osteoporosis/si [Side Effect] pathophysiology phlebography postpartum hemorrhage/si [Side Effect] postthrombosis syndrome/pc [Prevention] preeclampsia pregnancy pregnant woman priority journal protein C deficiency protein S deficiency radiation exposure recurrence risk risk factor skin allergy/si [Side Effect] smoking teratogenicity/co [Complication] teratogenicity/si [Side Effect] thorax radiography thrombocytopenia/si [Side Effect] thrombophilia transthoracic echocardiography twin pregnancy ultrasound vein blood flow *venous thromboembolism/di [Diagnosis] *venous thromboembolism/dt [Drug Therapy] *venous thromboembolism/ep [Epidemiology] *venous thromboembolism/pc [Prevention] *venous thromboembolism/th [Therapy] venous thromboembolism/dt [Drug Therapy] vertebra fracture/si [Side Effect] blood clotting factor 5 Leiden/ec [Endogenous Compound] blood clotting factor 8/ec [Endogenous Compound] brain natriuretic peptide/ec [Endogenous Compound] coumarin/ae [Adverse Drug Reaction] coumarin/dt [Drug Therapy] D dimer/ec [Endogenous Compound] dalteparin/do [Drug Dose] dalteparin/dt [Drug Therapy] dalteparin/sc [Subcutaneous Drug Administration] danaparoid/ae [Adverse Drug Reaction] danaparoid/dt [Drug Therapy] enoxaparin/do [Drug Dose] enoxaparin/dt [Drug Therapy] enoxaparin/sc [Subcutaneous Drug Administration] fondaparinux/dt [Drug Therapy] heparin/ae [Adverse Drug Reaction] heparin/do [Drug Dose] heparin/dt [Drug Therapy] heparin/iv [Intravenous Drug Administration] heparin/sc [Subcutaneous Drug Administration] heparinoid/ae [Adverse Drug Reaction] heparinoid/dt [Drug Therapy] low molecular weight heparin/ae [Adverse Drug Reaction] low molecular weight heparin/dt [Drug Therapy] low molecular weight heparin/sc [Subcutaneous Drug Administration] oral contraceptive agent phospholipid antibody/ec [Endogenous Compound] plasminogen activator inhibitor 1/ec [Endogenous Compound] plasminogen activator inhibitor 2/ec [Endogenous Compound] protein S/ec [Endogenous Compound] prothrombin/ec [Endogenous Compound] thrombin/ec [Endogenous Compound] thromboplastin/ec [Endogenous Compound] tinzaparin/do [Drug Dose] tinzaparin/dt [Drug Therapy] tinzaparin/sc [Subcutaneous Drug Administration] troponin I/ec [Endogenous Compound] warfarin/ae [Adverse Drug Reaction] warfarin/dt [Drug Therapy] compression leg ultrasound maternal age antepartum hemorrhage/si [Side Effect] anticoagulant therapy antithrombin deficiency article bleeding/si [Side Effect] blood clot lysis blood vessel injury breast cancer/co [Complication] central nervous system disease/si [Side Effect] cesarean section childhood cancer/co [Complication] compression garment computed tomographic angiography critical illness critical illness *deep vein thrombosis / *diagnosis / *drug therapy / *epidemiology / *prevention / *therapy deep vein thrombosis / drug therapy delivery diabetes mellitus disease association disease severity Doppler flowmetry dosage schedule comparison drug substitution drug withdrawal embryopathy / side effect fertilization in vitro fetal hemorrhage / side effect fetus outcome fibrinolysis high risk patient high risk pregnancy human hypertension immobilization infection infection complication injection site reaction / side effect labor low drug dose lung angiography lung embolism / diagnosis / drug therapy lung scintiscanning lung ventilation perfusion ratio maternal age maternal mortality mother neurologic disease / side effect nuclear magnetic resonance imaging obesity obstetric patient obstetrics oral contraception osteoporosis / side effect pathophysiology phlebography postpartum hemorrhage / side effect postthrombosis syndrome / prevention preeclampsia pregnancy pregnant woman priority journal protein C deficiency protein S deficiency radiation exposure recurrence risk risk factor skin allergy / side effect smoking teratogenicity / complication / side effect thorax radiography thrombocytopenia / side effect thrombophilia transthoracic echocardiography twin pregnancy ultrasound vein blood flow *venous thromboembolism / *diagnosis / *drug therapy / *epidemiology / *prevention / *therapy venous thromboembolism / drug therapy vertebra fracture / side effect bleeding / side effect article antithrombin deficiency anticoagulant therapy blood clot lysis antepartum hemorrhage / side effect blood vessel injury breast cancer / complication central nervous system disease / side effect cesarean section childhood cancer / complication compression garment computed tomographic angiography |
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