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2014, Número 1

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Neumol Cir Torax 2014; 73 (1)


Tromboembolia pulmonar en el embarazo y puerperio

Rojas-Sánchez AG, Navarro-de la Rosa G, Mijangos-Méndez JC, Campos-Cerda R

Idioma: Español
Referencias bibliográficas: 35
Paginas: 42-48
Archivo PDF: 214.76 Kb.


RESUMEN

La mujer embarazada tiene cinco veces el riesgo de desarrollar tromboembolia pulmonar (TEP) con respecto a las no embarazadas. Los cambios cardiovasculares y de la coagulación propios del embarazo pueden facilitar los eventos de TEP. El riesgo se incrementa en la presencia de otros factores: edad, multiparidad, lupus eritematoso sistémico y TEP previa. El proceso diagnóstico inicia con la sospecha clínica. La determinación de dímeros-D es útil principalmente por su valor predictivo negativo. La angiotomografía pulmonar helicoidal tiene una alta sensibilidad y especificidad en el diagnóstico, mientras que la arteriografía pulmonar sigue siendo el estándar de oro para el diagnóstico definitivo. El tratamiento de la TEP consiste en la anticoagulación tan pronto se establezca el diagnóstico. Tanto la heparina no fraccionada como la de bajo peso molecular son los medicamentos de elección sobre los antagonistas de la vitamina K, principalmente debido a que las heparinas no atraviesan la barrera útero-placentaria, presentan menos efectos adversos y tienen una vida media más corta.


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