Reyes ME, Martínez HN, Ibargüengoitia OF, Vargas TS, Vidal GV

Language: Spanish
References: 16
Page: 249-255
PDF size: 187.02 Kb.

ABSTRACT

Background: Pregnant patients have five-fold venous thrombosis than no pregnant, and its therapy is mainly with non-fractioned and low molecular weight heparin.
Objective: To know clinical characteristics, treatment and perinatal results of deep venous thrombosis associated to pregnancy at Instituto Nacional de Perinatologia.
Material and methods: Review of the files of patients with diagnosis, prenatal control, and resolution of deep venous thrombosis at Instituto Nacional de Perinatologia.
Results: A total of 45 cases with deep venous thrombosis and pregnancy are described, with: age 29.3 ± 6 years; gestations, 2.3 ± 1.2; body mass index, 27.3 ± 3.5. Risk factors: peripheral venous insufficiency, 17 (37.8%); obesity, 11 (24.4%); previous deep venous thrombosis, 10 (22.2%); antiphospholipid syndrome, 2 (4.4%); and protein S deficiency, 1 (2.2%). Diagnosis by gestational age: first trimester 10 (22%), second trimester 18 (40%), third trimester 15 (34%), and puerperium 2 (4%). Affected pelvic member: left, 32 (71%); right, 12 (27%); bilateral, 1 (2%). Initial treatment was always with non-fractionated heparin, and prevention of recurrence was made with acenocumarin in 41 cases (93%), and with non-fractionated heparin in 4 (7%). Resolution of pregnancy was 38.1 ± 2 weeks of gestation: vaginal delivery, 18 cases (40%); cesarean, 27 (60%). Weight at birth was 3,026 ± 464 g, with Apgar score ‹ 6 in one case. In four cases there were four therapy-derived complications (3 with echymosis and epistaxis and 1 with macroscopic hematuria).
Conclusions: Timely and appropriate therapy of deep venous thrombosis during pregnancy prevents thromboembolic complications, and generally is associated to satisfactory maternal and fetal results.

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