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venous thrombosis and pregnancy

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https://www.readbyqxmd.com/read/29739085/cerebral-venous-sinus-thrombosis-with-cerebral-hemorrhage-presenting-with-status-epilepticus-in-early-pregnancy
#1
Xuemin Feng, Teng Zhao, Jingyao Liu, Chunkui Zhou
BACKGROUND: CVST is an important cause of stroke during late pregnancy and in the puerperium, but it is seldom encountered during early pregnancy. We report a case of a 34-year-old woman presenting with convulsive status epilepticus in early pregnancy. METHODS: In this case, the cranial computed tomography detected hemorrhage. Magnetic resonance imaging revealed a bilateral hypointense signal involving the frontal lobes and a hyperintense lesion on the right temporal lobe on T1-weighted imaging, and a large bilateral hyperintense area involving the frontal lobes on T2-weighted and fluid-attenuated inversion recovery imaging...
April 1, 2018: Clinical Laboratory
https://www.readbyqxmd.com/read/29709455/the-approach-to-peripartum-management-of-anticoagulation-a-multidisciplinary-survey
#2
Sagar Rohailla, Ann Kinga Malinowski, Shital Gandhi, Anne McLeod, Rosane Nisenbaum, Nadine Shehata
OBJECTIVE: This study sought to determine whether there is practice variation in the treatment and prevention of acute venous thromboembolism (VTE) in pregnant patients, potentially to prioritize future studies. BACKGROUND: The risk of VTE during pregnancy is five-fold that of the non-pregnant state. Guidance is often lacking for the treatment and prophylaxis of VTE because there are few RCTs. METHODS: The study used a cross-sectional study design using a self-administered electronic questionnaire consisting of 11 case scenarios that were sent to hematologists, maternal-fetal medicine specialists, obstetricians and gynaecologists, and internal medicine specialists across Canada...
April 27, 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29701415/antiphospholipid-syndrome-and-acute-postpartum-limb-ischemia
#3
Inês Antunes, Carlos Pereira, Rui Machado, Duarte Rego, Vitor Ferreira, João Gonçalves, Gabriela Teixeira, Carlos Veiga, Daniel Mendes, Rui Almeida
INTRODUCTION: The diagnosis of Antiphospholipid syndrome (APS) implies the identification of antiphospoholipid antibodies and arterial/venous thrombosis or pregnancy loss. During pregnancy, there is an increased risk of thrombotic complications. METHODS: Present a case of acute lower limb ischemia in a patient with APS during postpartum period Materials/ Methods: review of a clinical case and available literature Results: Patient diagnosed with APS (triple antibody positive and antecedent of 3 previous abortions) underwent cesarean at 29 weeks of gestation...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29682116/treatment-outcomes-of-anticoagulant-therapy-and-temporary-inferior-vena-cava-filter-implantation-for-pregnancy-complicated-by-venous-thrombosis
#4
Nobuhiro Hara, Takamichi Miyamoto, Junji Yamaguchi, Takamasa Iwai, Sadahiro Hijikata, Keita Watanabe, Yuichiro Sagawa, Ryo Masuda, Ryoichi Miyazaki, Naoyuki Miwa, Masahiro Sekigawa, Tetsuo Yamaguchi, Yasutoshi Nagata, Toshihiro Nozato, Orie Kobayashi, Satoshi Umezawa, Toru Obayashi
Objective : Although deep vein thrombosis (DVT) followed by pulmonary thromboembolism (PE) is a critical complication during pregnancy, there have been few reports about its intrapartum management. We evaluated intrapartum management by using a temporary inferior vena cava filter (IVCF) in pregnant women with PE/DVT. Materials and Methods : Eleven women with PE/DVT during pregnancy between January 2004 and December 2016 were included. The patients were hospitalized for intravenous unfractionated heparin infusion after acute PE/DVT onset...
March 25, 2018: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29669399/the-impact-of-systemic-lupus-erythematosus-on-the-clinical-phenotype-of-antiphospholipid-antibody-positive-patients-results-from-antiphospholipid-syndrome-alliance-for-clinical-trials-and-international-networking-aps-action-clinical-database-and-repository
#5
Ozan Unlu, Doruk Erkan, Medha Barbhaiya, Danieli Andrade, Iana Nascimento, Renata Rosa, Alessandra Banzato, Vittorio Pengo, Amaia Ugarte, Maria Gerosa, Lanlan Ji, Maria Efthymiou, D Ware Branch, Guilherme Raires de Jesus, Angela Tincani, H Michael Belmont, Paul R Fortin, Michelle Petri, Esther Rodriguez, Guillermo J Pons-Estel, Jason S Knight, Tatsuya Atsumi, Rohan Willis, Stephane Zuily, Maria G Tektonidou
OBJECTIVE: Although systemic lupus erythematosus (SLE) is the most common autoimmune disease associated with antiphospholipid antibodies (aPL), limited data exist on the impact of SLE on the clinical phenotype of aPL-positive patients. The primary objective was to compare the clinical, laboratory, and treatment characteristics of aPL-positive patients with or without SLE. METHODS: A secure web-based data capture system stores patient demographics, and aPL-related clinical and laboratory characteristics...
April 18, 2018: Arthritis Care & Research
https://www.readbyqxmd.com/read/29629564/thrombin-activatable-fibrinolysis-inhibitor-polymorphisms-and-cerebral-venous-thrombosis-in-mexican-mestizo-patients
#6
Antonio Arauz, Nayelli Argüelles, Aurelio Jara, Jorge Guerrero, Miguel A Barboza
Thrombin-activatable fibrinolysis inhibitor (TAFI) gene polymorphisms have been proposed as a predisposing factor for cerebral venous thrombosis (CVT). We analyzed the association between CVT and TAFI single-nucleotide polymorphisms (rs3742264, rs2146881, and rs1926447) compared to healthy controls. Mexico Mestizo confirmed cases with CVT and age- and sex-matched controls with no history of venous thrombotic events were recruited from July 2006 to July 2015. Demographic, clinical, and imaging information was included in the analysis...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29602141/is-thromboprophylaxis-cost-effective-in-ovarian-hyperstimulation-syndrome-a-systematic-review-and-cost-analysis
#7
REVIEW
Kelly Comerford Wormer, Ayesha A Jangda, Farah A El Sayed, Katherine I Stewart, Sunni L Mumford, James H Segars
BACKGROUND: The majority of serious thromboembolic events occurring in assisted reproductive technologies (ART) are in women with ovarian hyperstimulation syndrome (OHSS). OBJECTIVES: The purpose of this study was to present a thorough review and cost analysis regarding the use of venous thromboembolism (VTE) prophylaxis in OHSS to inform clinical management. DATA SOURCES: Databases used were Pubmed and Embase, in addition to checking reference lists of retrieved articles (inception to November 2017)...
May 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29588577/the-level-of-awareness-and-the-attitude-of-patients-recommended-for-use-of-compression-stockings-in-turkish-society-and-investigation-of-the-factors-affecting-their-use
#8
Şinasi Manduz, Fatih Ada, Yusuf Ada
Objective: The purpose of this study was to reveal the treatment outlook, usage habits, and factors affecting these habits, in addition to providing suggestions for solutions for patients who are frequently recommended the use of compression stockings as treatment for conditions such as chronic venous insufficiency, deep vein thrombosis, lymphedema, and pregnancy. Methods: The study was conducted as a face-to-face questionnaire session with 1,004 patients who had previously registered at the cardiovascular surgeon's polyclinic of Sivas Numune Hospital between March 29, 2017, and October 31, 2017...
2018: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29573720/postpartum-blood-transfusion-and-hemorrhage-as-independent-risk-factors-for-venous-thromboembolism
#9
L Thurn, A Wikman, P G Lindqvist
INTRODUCTION: Profuse postpartum hemorrhage (PPH) and red blood cell (RBC) transfusion have been suggested to be associated with venous thromboembolic events (VTE). However, it is not fully clear if they are independent major risk factors. METHODS: Women who gave birth in the Stockholm area between 1999 and 2002 were those studied, i.e., before the implementation of guidelines for thromboprophylaxis in pregnancy. In this population-based cohort study the Swedish Medical Birth Registry was linked to the National Discharge Registry and to the transfusion database...
March 10, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29532755/homocysteine-and-hyperhomocysteinaemia
#10
Bozidarka L Zaric, Milan Obradovic, Vladan Bajic, Mohamed A Haidara, Milos Jovanovic, Esma R Isenovic
Homocysteine (Hcy) is thiol group containing the amino acid, which naturally occurs in all humans. Hcy is degraded in the body through two metabolic pathways, while a minor part is excreted through kidneys. The chemical reactions that are necessary for degradation of Hcy require the presence of the folic acid, vitamins B6 and B12. Consequently, the level of the total Hcy in the serum is influenced by the presence or absence of these vitamins. An elevated level of the Hcy, hyperhomocysteinemia (HHcy) and homocystinuria are connected with occlusive artery disease, especially in the brain, the heart, and the kidney, in addition to venous thrombosis, chronic renal failure, megaloblastic anemia, osteoporosis, depression, Alzheimer's disease, pregnancy problems, and others...
March 12, 2018: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/29485563/spontaneous-resolution-of-an-orbital-mass-after-delivery-a-diagnostic-challenge
#11
Zeynep Dadaci, Cengiz Kadiyoran, Mustafa Golen, Hilal Akay Cizmecioglu
The authors report a 35-year-old woman who presented 1 month after delivery with the complaint of pain behind her left eye which started during her pregnancy. The patient described increased fullness with dependent head position and pain on left gaze but she had no proptosis and her ocular examination was normal. Magnetic resonance imaging (MRI) revealed an intraconal mass with inhomogeneous contrast enhancement. As the authors did not suspect malignity and her ocular examination was normal without any signs of inflammation, the authors followed the patient closely...
May 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29471673/identifying-additional-risk-factors-for-thrombosis-and-pregnancy-morbidities-among-antiphospholipid-antibodies-carriers
#12
Yu Zuo, Jennifer Fan, Ravi Sarode, Song Zhang, Una E Makris, David R Karp, Yu-Min Shen
The evaluation of thrombotic and pregnancy risks associated with antiphospholipid antibodies (aPL)in individual patients without antiphospholipid syndrome (APS) clinical manifestation is challenging. Our aim is to identify additional risk factors or potential candidate "second hits" for APS clinical events in a large cohort of ethnically diverse aPL-positive patients. We included 219 consecutive aPL-positive patients who attended clinic at our institution. All patients had at least 1 persistent high titer (≥99 percentiles) aPL...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29470182/diagnosis-and-management-of-vte-in-pregnancy
#13
Kelley C McLEAN, Andra H James
Venous thromboembolism is a leading cause of maternal death. Because of the low absolute frequency of events, however, outcome-based clinical data are limited. Consequently, clinicians must additionally rely both on published guidelines and on extrapolation of data from studies focused on nonpregnant individuals. The diagnosis and treatment of deep vein thrombosis, pulmonary embolism, and cerebral vein and dural sinus thrombosis are complicated by pregnancy, and often require modifications to standard diagnostic and treatment algorithms outside of pregnancy...
June 2018: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29452956/comparison-of-face-to-face-interaction-and-the-electronic-medical-record-for-venous-thromboembolism-risk-stratification-using-the-2005-caprini-score
#14
Christopher J Pannucci, Kory I Fleming
OBJECTIVE: Perioperative venous thromboembolism (VTE) risk can be quantified with the 2005 Caprini score. The Caprini score has previously been validated by review of the electronic medical record (EMR) in >3000 plastic surgery patients. However, the accuracy of Caprini-based risk stratification using the EMR, as opposed to face-to-face contact with the patient, remains unknown. METHODS: Plastic and reconstructive surgery patients who had surgery under general anesthesia, required postoperative admission, and were started on enoxaparin prophylaxis were identified...
May 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29433369/postpartum-thromboprophylaxis-in-a-multireligious-cohort-a-retrospective-review-of-indications-and-uptake
#15
Hian Yan Voon, Ming Cheng Chai, Ling Yien Hii, Rafaie Amin, Haris Njoo Suharjono
Strategies to prevent mortality from obstetric venous thromboembolism begin with identification, risk stratification and subsequently, implementation of prophylactic measures. We sought to identify the burden of pharmacologic thromboprophylaxis in postpartum women, including the main clinical indications and its uptake in a multireligious population, with Islam as the official religion. A total of 2514 deliveries between 1st January to 31st December 2016, across three centres in Malaysia were reviewed retrospectively from hospital-based registries...
February 12, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29399535/deep-venous-thrombosis-in-pregnancy-incidence-pathogenesis-and-endovascular-management
#16
REVIEW
Paola Devis, M Grace Knuttinen
Deep venous thrombosis (DVT) during pregnancy is associated with high mortality, morbidity, and costs. Pulmonary embolism (PE), its most feared complication, is the leading cause of maternal death in the developed world. DVT can also result in long-term complications that include postthrombotic syndrome (PTS) adding to its morbidity. Women are up to 5 times more likely to develop DVT when pregnant. The current standard of care for this condition is anticoagulation. This review discusses the epidemiology, pathogenesis, prophylaxis and diagnosis of DVT during pregnancy, and then focuses on endovascular treatment modalities...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29385876/antiphospholipid-syndrome-the-best-prophet-of-the-future
#17
Olga Amengual, Tatsuya Atsumi
The antiphospholipid syndrome (APS) is an autoimmune disorder characterized by the occurrence of venous and arterial thromboses, often multiple, and obstetric-related adverse events in the presence of antiphospholipid antibodies (aPL). APS, first described in 1983, as thrombosis, abortion and cerebral disease, is nowadays recognised as a systemic disease with a wide constellation of clinical manifestations related to acute and chronic vascular lesions. The presence of aPL is the serological hallmark of APS representing a heterogeneous population of autoantibodies with many antigenic specificities directed to phospholipid-binding proteins, either alone or in combination with phospholipids...
May 2018: Modern Rheumatology
https://www.readbyqxmd.com/read/29378443/thrombolysis-in-pregnancy-a-literature-review
#18
Marina Sousa Gomes, Mariana Guimarães, Nuno Montenegro
BACKGROUND: Changes in the coagulation system during pregnancy and puerperium produce a physiological hypercoagulable state. These changes are thought to be the cause of the higher rates of deep vein thrombosis (DVT), pulmonary embolism (PE), stroke, and mechanical prosthetic valve thrombosis (PVT) during pregnancy. Thrombolysis can be a treatment option in this case. However, there are no available data from randomized controlled trials in pregnant patients and information about the security of thrombolytics in pregnancy is missing...
February 11, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29359796/the-dipep-diagnosis-of-pe-in-pregnancy-biomarker-study-an-observational-cohort-study-augmented-with-additional-cases-to-determine-the-diagnostic-utility-of-biomarkers-for-suspected-venous-thromboembolism-during-pregnancy-and-puerperium
#19
Beverley J Hunt, Kiran Parmar, Kimberley Horspool, Neil Shephard, Catherine Nelson-Piercy, Steve Goodacre
This study aimed to estimate the diagnostic utility of biomarkers for suspected venous thromboembolism (VTE) in pregnancy and the puerperium. Research nurses/midwives collected blood samples from 310 pregnant/postpartum women with suspected pulmonary emboli (PE) and 18 with diagnosed deep vein thrombosis (DVT). VTE was diagnosed using imaging, treatment and adverse outcome data. Primary analysis was limited to women with conclusive imaging (36 with VTE, 247 without). The area under the curve (AUC) for each biomarker was: activated partial thromboplastin time 0·669 (95% confidence interval 0·570-0·768), B-type natriuretic peptide 0·549 (0·453-0·645), C-reactive protein 0·542 (0·445-0·639), Clauss fibrinogen 0·589 (0·476-0·701), D-Dimer (by enzyme-linked immunosorbent assay) 0·668 (0·561-0·776), near-patient D-Dimer 0·651 (0·545-0·758), mid-regional pro-atrial natriuretic peptide 0·524 (0·418-0·630), prothrombin fragment 1 + 2 0·562 (0·462-0·661), plasmin-antiplasmin complexes 0·639 (0·536-0·742), prothombin time 0·613 (0·508-0·718), thrombin generation lag time 0·702 (0·598-0·806), thrombin generation endogenous potential 0·559 (0·437-0·681), thrombin generation peak 0·596 (0·478-0·715), thrombin generation time to peak 0·655 (0·541-0·769), soluble tissue factor 0·531 (0·424-0·638) and serum troponin 0·597 (0·499-0·695)...
March 2018: British Journal of Haematology
https://www.readbyqxmd.com/read/29342292/clinical-utility-of-the-global-anti-phospholipid-syndrome-score-for-risk-stratification-a-pooled-analysis
#20
Savino Sciascia, Massimo Radin, Giovanni Sanna, Irene Cecchi, Dario Roccatello, Maria Laura Bertolaccini
Objective: Recently, our group conceived a risk score for clinical manifestations of APS (the global APS score, or GAPSS) that takes into account the combination of independent cardiovascular risk factors and the aPL positivity profile. These include hyperlipidaemia, arterial hypertension, aCL, anti-β2 glycoprotein-I, aPS-PT and the LA. A complementary version, the adjusted GAPSS (aGAPSS), which excludes aPS-PT, was also designed. The aim of our study was to systematically review the literature to assess the clinical utility of the GAPSS and aGAPSS for risk stratification of any APS clinical manifestation...
January 12, 2018: Rheumatology
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