Enfermedad tromboembólica venosa en obstetricia
Enfermedad tromboembólica venosa en obstetricia
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Introducción: la Enfermedad Tromboembólica Venosa (ETV) incluyen: trombosis venosa superficial, venosa profunda, de las venas ováricas, pélvica séptica y el trombo embolismo pulmonar.
Objetivo: realizar revisión sobre factores de riesgo, diagnóstico, manejo y tratamiento de ETV en pacientes obstétricas.
Metodología: revisión temática que incluye estudios clínicos y epidemiológicos, revisiones sistemáticas, temáticas, consensos, reuniones de expertos, guías clínicas y protocolos sobre ETV en el embarazo. Revisadas las bases de datos PubMed, ScienceDirect, OvidSP y Scielo, durante los años 2000 y 2011, en los idiomas inglés y español.
Resultados: la búsqueda arrojó 214 estudios. 76 cumplieron con los criterios de inclusión y fueron revisados. Existe una buena aproximación a los factores de riesgo para el desarrollo de ETV en mujeres gestantes. Existe un test clínico para identificar mujeres con riesgo de TVP. Existen estudios de imagen que ofrecen diferentes porcentajes de sensibilidad y especificidad. La gammagrafía por perfusión es una buena y segura herramienta en la mujer gestante. El diagnóstico temprano debe ser seguido de una temprana y adecuada acción terapéutica. HBPM ha reemplazado el uso de la HNF.
Conclusiones: se debe identificar la presencia de factores de riesgo en toda la población gestante, de acuerdo a los hallazgos; realizar medidas terapéuticas generales o farmacológicas. Rev.cienc.biomed. 2012;3(1):124-135
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Doyle NM, Monga M. Thromboembolic disease in pregnancy. Obstet Gynecol Clin N Am. 2004; 31:319-344.
Davis JD. Prevention, diagnosis, and treatment of venous thromboembolic complications of gynecologic surgery. Am.J Obst.Gynecol. 2001;184(4):759-765.
Calderwood CJ. Thromboembolism and thrombophilia in pregnancy. Curr Obstet Gynaecol. 2006;16:321–326.
Pereira AQ, Krieger BP. Pulmonary complications of pregnancy. Clin Chest Med. 2004;25:299-310.
Dennis RJ, Roa JH, Villadiego J, Méndez F, Vieda E, Restrepo H. Profilaxis de la tromboembolia venosa en Colombia. Biomédica. 2011;31:200-208.
Greer IA. Prevention and management of venous thromboembolism in pregnancy. Clinics in Chest Medicine. 2003;24(1):123-137.
Bick RL, Haas S Thromboprophylaxis and thrombosis in medical, surgical, trauma, and obstetric/gynecologic patients. Hematology/oncology Clin N Am. 2003;17(1):217-258.
Ridker PM. Inherited risk factors for venous thromboembolism: implications for clinical practice. Clinical Cornerstone. 2002;4(6):18-30.
Primer consenso Latinoamericano para el manejo del tromboembolismo venoso. Forum venoso. 2000;1(4):5-73.
Gómez J. Tromboprofilaxis en cirugía ginecológica y obstétrica. XIII Curso de actualización en obstetricia y ginecología. Universidad de Antioquia. 2005.
Bergqvist D. Thromboprophylaxis in gynaecologic surgery. Thrombosis Research 2009; 123 3(Suppl.): S5–S7.
James AH, Jamison MG, Brancazio L, Myer E. Venous thromboembolism during pregnancy and the postpartum period: Incidente, risk factors and mortality. Am J Obstet Gynecol.
;194:1311-1315.
Bauer KA, Rosendaal FR, Heit JA. Hypercoagulability: Too many tests, too much conflicting data. Hematology. 2002;1:253-257.
Vucic N, Cala K, Rancic I, Pticar R. Therapy and prevention of deep venous thrombosis and pulmonary embolism in gynecology and obstetrics. Acta Med Croatica. 2003;57(2):123-130.
Rodger MA, Walker M, Wells PS.Diagnosis and treatment of venous thromboembolism in pregnancy. Best Pract Res Clin Haematol. 2003;16(2):279-296.
Hague WM, Dekker GA. Risk factors for trombosis in pregnancy. Best Pract Res Clin Haematol. 2003;16(2):197-210.
Kim V, Spandorfer J. Epidemiology of venous thromboembolic disease. Emerg Med Clin N Am. 2001;19(4):839-859.
López JA, Kearon C, Lee A. Deep venous trombosis. Haematology. 2004;1:439
Lip YH, Chin GB, Blann AD. Cancer and the prothrombotic state. Lancet Oncology. 2002;3(1):27-34.
PrandonI P. Adquired risk factors for venous thromboembolism in medical patients. Haematology. 2005;458-461.
Bomheli T, Raddatz-Mueller P, Fehr J. Coagulation activation markers do not correlate with the clinical risk of thrombosis in pregnant women. Am.J. Obst. Gynecol. 2001;184(3):382-389.
Kujovich JL. Thrombophilia and pregnancy complications. Am J Obstet Gynecol. 2004;191:412-424.
Eichinger S. D-dimer testing in pregnancy. Semin Vasc Med. 2005;5(4):375-378
Eichinger S. D-dimer testing in pregnancy. Pathophysiol Haemost Thromb. 2004;33:327-329
Bockenstedt PL. Management of Hereditary Hypercoagulable Disorders Hematology. 2006;1:444-450.
Marik PE. Venous thromboembolism in pregnancy. Clin Chest Med. 2010; 31:731-740.
Heilmann L, Schneider D, Von Tempelhoff GF. Antithrombotic therapy in high-risk pregnancy. Hematology/oncology Clin N Am. 2000;14(5):1133-1150.
Martinelli I, De Stefano V, Taioli E, Paciaroni K, Rossi E, Mannucci PM. Inherited thrombophilia and first venous thromboembolism during pregnancy and puerperium. Thromb Haemost. 2002;87(5):791-795.
Pabinger I, Grafenhofer H. Pregnancy-associated thrombosis. Wien Klin Wochenschr. 2003;115(13-14):482-484.
Danilenko-Dixon DR, Heit JA, Silverstein MD, Yawn BP, Petterson TM, Lohse CM. et al. Risk factors for deep vein thrombosis and pulmonary embolism during pregnancy or post partum: a population-based, case-control study. Am J Obstet Gynecol. 2001;184(2):104-110.
Heit JA, Kobbervig CE, James AH, Petterson TM, Bailey KR, Melton LJ. Trends in the incidence of venous thromboembolism during pregnancy or postpartum: a 30 year population-based
study. Ann Intern Med. 2005;143(10):697-706.
Cinsberg JS, Greer I; HIRSH J. Use of antitrhombotic agents during pregnancy. Chest 2001;119:122S-131S.
Nelson SM, Greer IA. Thrombophilia and the risk for venous thromboembolism during pregnancy, delivery, and puerperium. Obstet. Gynecol Clin N Am. 2006;33:413-427.
Sia WW, Powrie RO, Cooper AB, Larson L, Phipps M, Spencer P; et al. The incidence of deep vein thrombosis in women undergoing cesarean delivery. Thrombosis Research.2009;123:550–555.
Bates SM. Management of pregnant women with thrombophilia or a history of venous thromboembolism. Hematology. 2007;143-150.
Marik PE, Plante L. Venous thromboembolic disease and pregnancy. N Engl J Med. 2008;359:2025-2033.
Tan JY. Thrombophilia in pregnancy. Ann Acad Med Singapore. 2002;31(3):328-34.
Stone SE, Morris TA. Pulmonary embolism and pregnancy. Critical Care Clinics. Med. 2004; 20:661-677.
Chan WS, Ginsberg JS. Diagnosis of deep vein trombosis and pulmonary embolism in pregnancy. Thromb Res. 2002;107:85-91.
Stone SE, Morris TA. Pulmonary embolism during and after pregnancy. Crit. Care. Med. 2005;33 (10Suppl): S294-300.
Rosenberg VA, Lockwood CHJ. Thromboembolism in pregnancy. Obstet. Gynecol Clin N Am. 2007;34:481–500.
Scarvelis D, Wells PS Diagnosis and treatment of deep-vein thrombosis Canadian Medical Association J. 2006;175(9):1087-1092.
Clark P. Maternal venous thrombosis Eur J Obstet Gynecol Reprod Biol. 2008;139:3–10.
Ho W, Hankey GJ, Lee C, Eikelboom JW. Venous thromboembolism: diagnosis and management of deep venous thrombosis.MJA 2005;182:476-481.
RCOG. The acute management of thrombosis and embolism during pregnancy and the puerperium. Green-top Guideline. 2010. No.37b
Fields JM, Goyal M. Venothromboembolism. Emerg Med Clin N Am. 2008;26:649-683.
Bates S, Ginsberg J. How we manage venous thromboembolism during pregnancy. Blood. 2002;100(10):3470-3478.
James AH. Prevention and management of venous thromboembolism in Pregnancy. Am J Med. 2007;120:S26–S34.
Lombaard H, Soma-Pillay P, Farrell EL. Managing acute collapse in pregnant women. Best Prac Res Clin Obstet Gynaecol. doi:10.1016/ j.bpobgyn.2009.01.005
Dresang LT, Fontaine P, Leeman L, King VJ. Venous
Thromboembolism During Pregnancy. Am Fam Physician. 2008;77:1709-1716.
Eichinger S. Diagnostic issues of VTE in pregnancy. Thrombosis Research. 2009;123 Suppl.2:S38–S40.
Bates SM, Greer IA, Hirsh J, Ginsberg JS. Use of Antithrombotic Agents during Pregnancy. The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004;126(3):627S-644S.
Jilma B, Kamath S, Lip G. Antithrombotic therapy in special circumstances. I-pregnancy and cancer BMJ. 2003;326:37-40
McRae SJ, Ginsberg JS. Initial treatment of venous thromboembolism. Circulation. 2004;110:I-3.
Ginsberg JS, Greer I, Hirsh J. Use of antithrombotic agents during pregnancy Chest. 2001;119:122S-131S.
Bauersachs RM. Treatment of venous thromboembolism during pregnancy. Thrombosis Research. 2009;123 (Suppl-2):S45–S50
Eldor A. Thrombophilia, thrombosis and pregnancy. Thromb Haemost. 2001; 86:104-111.
Khare M, Nelson-Piercy C. Acquired thrombophilias and pregnancy. Best Pract Res Clin Obstet Gynaecol. 2003;17(3):491-507.
Snow V, Qaseem A, Barry P, Hornbake ER; Rodnick JE; Tobolic T et al. Management of venous thromboembolism: A clinical practice guideline from the American College of Physicians and
the American Academy of Family Physicians. Ann Fam Med. 2007;5:74-80.
Greer IA. Low molecular weight heparin for pregnancy complications? Thrombosis Research .2009;123(Suppl-3):S22–S25
Ulander V-M, Stenqvist P, Kaaja R. Treatment of deep venous thrombosis with low-molecularweight heparin during pregnancy. Thrombosis Research 2002;106:13-17.
Clark P, Bates SM. North American and British guidelines for anti-thrombotic therapy: are we reaching consensus? Thrombosis Research.2009;123(Suppl-2):S111–S123.
Zotz R, Gerhardt A, Scarf RE. Inherited thrombophilia and gestational venous thromboembolism. Best Pract. Res. Clin. Haematol. 2003;16(2):243-259.
Hirsh J, Warkentin Te, Shaughnessy S, Anand S, Halperin Jl, Raschk R. et al. Heparin and low-molecular-weight heparin mechanisms of action, harmacokinetics, dosing, monitoring,
efficacy, and safety Chest. 2001;119:64S-94S.
Sarig G, Vidergor G, Brenner B. Assessment and management of high-risk pregnancies in women with thrombophilia. Blood Reviews. doi:10.1016/j.blre.2008.11.001.
Dunn C, Jarvis B. Dalteparina. Drugs. 2000;60:3-44.
Gris J, Lissalde-Lavigne G, Quere I, Mares P. Monitoring the effects and managing the side effects of anticoagulation during pregnancy. Obstet gynecol. 2006;33:397-411.
Eldor A. The use of low- molecular- weight heparin for the management of venous thromboembolism in pregnancy. Eur J Obstet Gynecol Reprod Biol. 2002;104:3-13.
A working group on behalf of the obstetric medicine group of Australia. Anticoagulation in pregnancy and the puerperium. MJA. 2001;175:258-263.
Chasen ST. Peripartum and periopetive management of the anticoagulated patient. Obstet Gynecol. Clin N Am. 2006;33:493-497
Institute for clinical systems improvement Health care guideline: Venous thromboembolism diagnosis and treatment. 11 edt. 2011. www.icsi.org
Bates SM. Treatment and prophylaxis of venous thromboembolism during pregnancy. Thromb Res. 2003;108:97-106.
Greer IA. Prevention of venous thromboembolism in pregnancy. Best Practice Res. Clin. Haematol. 2003;16(2):261-278.
Geert W, Pineo G, Heit Ja, Bergqvist D, Lassen M, Colwell CW. et al. Prevention of venous thromboembolism. Chest. 2004;126:338s-400S.
Casele HL. The use of unfractionated heparin and low molecular weight heparins in pregnancy. Clin Obstet Gynecol. 2006;49(4):895-905.
Hyers TM. Long-term anticoagulation prophylaxis following acute thromboembolism. Dis Mon.2005;51:158-165.
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