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thromboembolism in pregnancy

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https://www.readbyqxmd.com/read/28331377/management-of-systemic-lupus-erythematosus-during-pregnancy-challenges-and-solutions
#1
REVIEW
Caroline L Knight, Catherine Nelson-Piercy
Systemic lupus erythematosus (SLE) is a chronic, multisystem autoimmune disease predominantly affecting women, particularly those of childbearing age. SLE provides challenges in the prepregnancy, antenatal, intrapartum, and postpartum periods for these women, and for the medical, obstetric, and midwifery teams who provide their care. As with many medical conditions in pregnancy, the best maternal and fetal-neonatal outcomes are obtained with a planned pregnancy and a cohesive multidisciplinary approach. Effective prepregnancy risk assessment and counseling includes exploration of factors for poor pregnancy outcome, discussion of risks, and appropriate planning for pregnancy, with consideration of discussion of relative contraindications to pregnancy...
2017: Open Access Rheumatology: Research and Reviews
https://www.readbyqxmd.com/read/28329059/anticoagulation-for-pregnant-women-with-mechanical-heart-valves-a-systematic-review-and-meta-analysis
#2
Rohan D'Souza, Jackie Ostro, Prakesh S Shah, Candice K Silversides, Ann Malinowski, Kellie E Murphy, Mathew Sermer, Nadine Shehata
Aims: To review maternal and foetal outcomes in women with mechanical heart valves (MHVs) treated with vitamin-K antagonists (VKAs), first-trimester heparin followed by VKAs (sequential treatment), low molecular weight heparin (LMWH) and unfractionated heparin (UFH) during pregnancy, in order to inform practice. Methods and results: Medline, Embase and Central were searched from inception until February 2016. Two reviewers independently screened 1786 titles, reviewed 110 full-texts and extracted data and assessed risk-of-bias from 46 articles...
March 9, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28304315/using-antifibrinolytics-in-the-peripartum-period-concern-for-a-hypercoagulable-effect
#3
H K Ahmadzia, E L Lockhart, S M Thomas, I J Welsby, M R Hoffman, A H James, A P Murtha, G K Swamy, C A Grotegut
INTRODUCTION: Although antifibrinolytic agents are used to prevent and treat hemorrhage, there are concerns about a potential increased risk for peripartum venous thromboembolism. We sought to determine the impact of tranexamic acid and ɛ-aminocaproic acid on in vitro clotting properties in pregnancy. METHODS: Blood samples was obtained from healthy pregnant, obese, and preeclamptic pregnant women (n = 10 in each group) prior to delivery as well as from healthy non-pregnant controls (n = 10)...
March 16, 2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28302138/congenital-giant-left-atrial-appendage-aneurysm-a-case-report
#4
Yan Chen, Yun Mou, Li-Jun Jiang, Shen-Jiang Hu
BACKGROUND: Congenital left atrial appendage aneurysm (LAAA) is a rare cardiac anomaly with potentially serious complications, including life-threatening systemic thromboembolism, atrial tachyarrhythmia, and cardiac dysfunction. Currently, early surgical intervention is generally recommended to prevent these complications. CASE PRESENTATION: We present a case of congenital giant LAAA in a female patient who successfully completed pregnancy and underwent caesarean section with no obvious complications...
March 16, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28290648/deep-venous-thrombosis-and-pulmonary-embolism-current-therapy
#5
Jason Wilbur, Brian Shian
Pulmonary embolism and deep venous thrombosis are the two most important manifestations of venous thromboembolism (VTE), which is the third most common life-threatening cardiovascular disease in the United States. Anticoagulation is the mainstay of VTE treatment. Most patients with deep venous thrombosis or low-risk pulmonary embolism can be treated in the outpatient setting with low-molecular-weight heparin and a vitamin K antagonist (warfarin) or direct-acting oral anticoagulants. Inpatient treatment of VTE begins with parenteral agents, preferably low-molecular-weight heparin...
March 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28282779/sequential-use-of-foley-catheter-with-misoprostol-for-second-trimester-pregnancy-termination-in-women-with-and-without-caesarean-scars-a-prospective-cohort-study
#6
Melih Velipasaoglu, Cem Yagmur Ozdemir, Burcu Ozek, Reyhan Ayaz, Huseyin Mete Tanir
PURPOSE: The aim of this study is to evaluate the effectiveness and safety of misoprostol and Foley catheter in second trimester termination in women with and without caesarean section (CS) scars. MATERIALS AND METHODS: Women with an indication for pregnancy termination between 14 and 22 completed weeks of gestation were included to the study. Enrolled women were allocated into three groups: (1) women with no history of CS, (2) women with one CS and (3) women with ≥2 CS...
February 28, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28262917/bed-rest-with-and-without-hospitalisation-in-multiple-pregnancy-for-improving-perinatal-outcomes
#7
REVIEW
Katharina da Silva Lopes, Yo Takemoto, Erika Ota, Shinji Tanigaki, Rintaro Mori
BACKGROUND: Strict or partial bed rest in hospital or at home is commonly recommended for women with multiple pregnancy to improve pregnancy outcomes. In order to advise women to rest in bed for any length of time, a policy for clinical practice needs to be supported by reliable evidence and weighed against possible adverse effects resulting from prolonged activity restriction. OBJECTIVES: The objective of this review is to assess the effectiveness of bed rest in hospital or at home to improve perinatal outcomes in women with a multiple pregnancy...
March 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28262243/pitfalls-in-the-diagnostic-management-of-pulmonary-embolism-in-pregnancy
#8
Cécile Tromeur, Liselotte M van der Pol, Frederikus A Klok, Francis Couturaud, Menno V Huisman
Women are at increased risk of venous thromboembolism (VTE) during pregnancy and VTE remains one of the main causes of maternal mortality in developed countries (Konstantinides SV, et al. Eur Heart J 2014; 35(43):3033-69, 69a-69k). Although an accurate diagnosis of acute pulmonary embolism (PE) in pregnant patients is thus of crucial importance, the diagnostic management of suspected PE is challenging for this specific patient category. As D-dimer levels increase physiologically throughout pregnancy, the optimal D-dimer threshold to rule out PE during pregnancy remains unknown...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28262237/outcome-after-discontinuing-anticoagulant-therapy-in-women-with-venous-thromboembolism-during-hormonal-use
#9
Ángeles Blanco-Molina, Javier Trujillo-Santos, Raffaele Pesavento, Vladimir Rosa, Conxita Falgá, Carles Tolosa, Lucia Mazzolai, Ángel Sampériz, Rita Duce, Manuel Monreal
INTRODUCTION: Whether women developing venous thromboembolism (VTE) while using hormonal therapy should be classified as having "unprovoked" or "provoked" VTE is controversial. METHODS: We used the RIETE (Registro Informatizado Enfermedad TromboEmbólica) database to compare the rate of symptomatic VTE recurrences after discontinuing anticoagulation in 3 subgroups of women aged ≤50years without cancer, pregnancy or puerperium: (1) those with hormonal therapy and no additional risk factors (hormonal users only); (2) those with unprovoked VTE; and (3) those with additional risk factors, with or without hormonal therapy...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28256367/impact-of-systemic-lupus-erythematosus-on-maternal-and-fetal-outcomes-following-pregnancy-a-meta-analysis-of-studies-published-between-years-2001-2016
#10
REVIEW
Pravesh Kumar Bundhun, Mohammad Zafooruddin Sani Soogund, Feng Huang
BACKGROUND: Previous research has already shown systemic lupus erythematosus (SLE) to have severe consequences on pregnancy outcomes. However, insufficient number of participants, which were mainly limited to one particular region, limited outcomes analyzed and lack of evidence based analysis to support systematic reviews of the literature were the limitations observed. Therefore, by improving these limitations, we aimed to systematically show the impact of SLE on maternal and fetal outcomes following pregnancy...
February 27, 2017: Journal of Autoimmunity
https://www.readbyqxmd.com/read/28247972/clinical-relevance-of-hypercoagulability-and-possible-hypofibrinolysis-associated-with-estrone-and-estriol
#11
Albe C Swanepoel, Priyaa Naidoo, Vance G Nielsen, Etheresia Pretorius
Estrone (E1 ) and Estriol (E3 ) are endogenous female hormones, present in increased concentrations during female specific physiological processes (menopause and pregnancy respectively) that are associated with increased venous thrombotic risk. These hormones are also used as hormone therapies that are also associated with increased thromboembolism risk. Viscoelastic analysis revealed no significant difference to clot formation after hormone addition, however morphological analysis showed that the addition of both E1 and E3 result in fibrin clots composed of thinner fibrin fibers arranged in dense matted networks...
March 1, 2017: Microscopy Research and Technique
https://www.readbyqxmd.com/read/28231636/personalized-thromboprophylaxis-using-a-risk-score-for-the-management-of-pregnancies-with-high-risk-of-thrombosis-a-prospective-clinical-study
#12
Y Dargaud, L Rugeri, C Fleury, C Battie, P Gaucherand, C Huissoud, R C Rudigoz, H Desmurs-Clavel, J Ninet, M C Trzeciak
BACKGROUND: Patients with thrombophilia and/or a history of venous thromboembolism (VTE) are at risk of thrombosis during pregnancy. A risk score for pregnancies with increased risk of VTE was previously described by our group (Lyon-VTE-score). OBJECTIVES: The aim of this prospective study was to assess the efficacy and safety of our score-based prophylaxis strategy in 542 pregnancies managed between 2005 and 2015 in Lyon University Hospitals. PATIENTS/METHODS: Of 445 patients included in the study, 36 had several pregnancies during the study period...
February 23, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28208204/thrombophilic-evaluation-in-patients-with-acute-pulmonary-embolism
#13
Scott M Stevens, Jack E Ansell
Patients with acute pulmonary embolism (PE) are often tested for thrombophilias, which are hereditary and acquired conditions that predispose to thrombosis. If a hereditary condition is identified, then testing is often performed on members of the patient's family. Testing for these conditions can be complex, as the presence of acute thrombosis and antithrombotic therapies can make the results of many tests unreliable. Many risk factors for thrombosis exist that are not routinely assessed by laboratory testing, and it is likely that many hereditary thrombophilia conditions remain to be discovered...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28179267/obesity-and-pregnancy-mechanisms-of-short-term-and-long-term-adverse-consequences-for-mother-and-child
#14
REVIEW
Patrick M Catalano, Kartik Shankar
Obesity is the most common medical condition in women of reproductive age. Obesity during pregnancy has short term and long term adverse consequences for both mother and child. Obesity causes problems with infertility, and in early gestation it causes spontaneous pregnancy loss and congenital anomalies. Metabolically, obese women have increased insulin resistance in early pregnancy, which becomes manifest clinically in late gestation as glucose intolerance and fetal overgrowth. At term, the risk of cesarean delivery and wound complications is increased...
February 8, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28168066/management-of-venous-thromboembolism-in-patients-with-hereditary-antithrombin-deficiency-and-pregnancy-case-report-and-review-of-the-literature
#15
Mohammad Refaei, Lydia Xing, Wendy Lim, Mark Crowther, Kochawan Boonyawat
Background. Hereditary antithrombin deficiency is a thrombogenic disorder associated with a 50-90% lifetime risk of venous thromboembolism (VTE), which is increased during pregnancy and the puerperium in these patients. We present a case of a woman with antithrombin (AT) deficiency who presented with a VTE despite therapeutic low molecular weight heparin (LMWH). Though the pregnancy was deemed unviable, further maternal complications were mitigated through the combined use of therapeutic anticoagulation and plasma-derived antithrombin concentrate infusions to normalize her functional antithrombin levels...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/28166924/-lifestyle-recommendations-for-prevention-of-spontaneous-preterm-birth-in-asymptomatic-pregnant-women
#16
E Maisonneuve
OBJECTIVES: To establish recommendations for lifestyle of pregnant women and its impact on spontaneous preterm births. MATERIAL AND METHODS: We searched Pubmed and Cochrane databases and checked reference lists of retrieved studies. This review of the literature concerns only women who have no symptoms for the ongoing pregnancy. RESULTS: Concerning maternal occupation during pregnancy, there is a mild increase of the risk of preterm birth only for women who work more than 40hours a week or who have hard working conditions according to a fatigue score (LE2)...
December 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/28149659/dyslipidemia-and-its-relationship-with-antiphospholipid-antibodies-in-aps-patients-in-north-kerala
#17
Shajit Sadanand, Binoy J Paul, Emil J Thachil, Rejadheesh Meletath
OBJECTIVE: Antiphospholipid antibody syndrome (APS) is one of the most common acquired thrombophilic disorders resulting in arterial and venous thromboses. APS is a major cause for cerebrovascular accidents or stokes, myocardial infarction, venous thromboembolism and recurrent abortions/pregnancy losses especially in young patients. APS patients have an increased risk of atherosclerotic cardiovascular events. There are only two studies on lipid abnormalities in APS patients. None of them have studied the relationship between individual laboratory tests for APS and lipid profile abnormalities...
December 2016: European Journal of Rheumatology
https://www.readbyqxmd.com/read/28135041/inflammatory-bowel-disease-and-venous-thromboembolism-during-pregnancy-and-the-postpartum-period
#18
A T Hansen, R Erichsen, E Horváth-Puhó, H T Sørensen
Essentials Risk of pregnancy-related venous thromboembolism may be increased in inflammatory bowel disease. We performed a study on inflammatory bowel disease and pregnancy-related venous thromboembolism. Inflammatory bowel disease is a risk factor for pregnancy-related venous thromboembolism. Proper disease control before conception is pivotal to avoid venous thromboembolism. SUMMARY: Background The incidence of inflammatory bowel disease (IBD) increases, and thus is more common, in pregnant women...
January 30, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28101117/maternal-mortality-ratio-and-causes-of-death-in-iri-between-2009-and-2012
#19
Marzieh Vahiddastjerdy, Nasrin Changizi, Abas Habibollahi, Leila Janani, Zahra Farahani, Farah Babaee
Objective: The Maternal Mortality Ratio is an important health indicator. We presented the distribution and causes of maternal mortality in Islamic Republic of Iran. Materials and methods: After provision of an electronic Registry system for date entry, a descriptive-retrospective data collection had been performed for all maternal Deaths in March 2009- March 2012. All maternal deaths and their demographic characteristic were identified by using medical registries, death certificates, and relevant codes according to International Classification of Diseases (ICD-9) during pregnancy, labor, and 42 days after parturition...
September 2016: Journal of Family & Reproductive Health
https://www.readbyqxmd.com/read/28097445/pregnancy-outcomes-in-hiv-positive-women-a-retrospective-cohort-study
#20
Kholoud Arab, Andrea R Spence, Nicholas Czuzoj-Shulman, Haim A Abenhaim
PURPOSE: In the United States, an estimated 8500 HIV (human immunodeficiency virus) positive women gave birth in 2014. This rate appears to be increasing annually. Our objective is to examine obstetrical outcomes of pregnancy among HIV-positive women. METHODS: A population-based cohort study was conducted using the Nationwide Inpatient Sample database (2003-2011) from the United States. Pregnant HIV-positive women were identified and compared to pregnant women without HIV...
January 17, 2017: Archives of Gynecology and Obstetrics
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