medigraphic.com
Órgano Oficial de la Sociedad Mexicana de Angiología y Cirugía Vascular

2012, Number 2

<< Back Next >>

Rev Mex Angiol 2012; 40 (2)

Enfermedad tromboembólica venosa durante el embarazo y puerperio. Descripción de dos casos clínicos y revisión de la literatura de su manejo con filtros de vena cava inferior

Román-Guzmán E, Ruiz-Mercado H, Moncayo-Piña C, Saavedra-Uribe J, Acosta-Tovar M, Blanco-Chávez D, Hernández-Aragón R, Romero-García FI

Language: Spanish
References: 16
Page: 61-67
PDF size: 334.44 Kb.


ABSTRACT

Coagulation changes during pregnancy predispose to thromboembolic and are the most common direct cause of maternal mortality. The long-term use of heparin is associated with complications such as bleeding, thrombocytopenia and osteoporosis. Low-molecular-weight heparin is an alternative however is associated to osteoporosis and thrombocytopenia. Coumarin derivatives crosses the placenta and may cause fetal complications. It is associated with a risk of teratogenesis and an increased risk of miscarriage, fetal and maternal haemorrhage, neurological problems in the baby and stillbirth. Placement of an inferior vena cava filter is indicated when recurrent thromboembolism occurs despite adequate anticoagulation or when anticoagulation is contraindicated. It may prevent life-threatening complications such as pulmonary embolism. Limited information is available about the effects of IVC filter use on pregnancy outcome. We present two cases of placement of vena caval filter: one in a pregnancy and another in the immediate postpartum period and a revision in the literature.


REFERENCES

  1. Reyes ME, Martínez HN, Ibargüengoitia OF, Vargas TS, Vidal GV. Experiencia en el tratamiento de pacientes embarazadas con trombosis venosa profunda en el Instituto Nacional de Perinatología. Ginecol Obstet Mex 2008; 76(5): 249-55.

  2. Serrano LR, Fink JG, Monroy LB, Serrano GG, Guerrero AG, Gómez LR. Colocación de filtros de vena cava en pacientes embarazadas con trombosis venosa profunda. Cirujano General 2006; 28(1): 33-6.

  3. Blickstein I, et al. Trombofilia y salud en la mujer. Clínicas obstétricas y ginecológicas de Norteamérica 2006; 33(3): 347-507.

  4. Kent N, et al. Prevention and treatment of venous thromboembolism (VTE) in obstetrics. Supplement of the Journal SOGC 2000; 22(9): 1-8.

  5. Shian CW, et al. A red blood cell agglutination D-dimer test to exclude deep venous thrombosis in pregnancy. Ann Intern Med 2007; 147: 165-70.

  6. Chan WS, Ray JG, Murray S, Coady GE, Coates G, Ginsberg JS. Suspected pulmonary embolism in pregnancy clinical presentation, results of lung scanning, and subsequent maternal and pediatric outcomes. Arch Intern Med 2002; 162: 1170-5.

  7. Winer-Muram HT, Boone JM, Brown HL, Jennings SG, Mabie WC, Lombardo GT. Pulmonary embolism in pregnant patients: fetal radiation dose with helical CT1. Radiology 2002; 224: 487-92.

  8. 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: 627-44.

  9. AbuRahma AF, Mullins DA, Charleston WV. Endovascular caval interruption in pregnant patients with deep vein thrombosis of the lower extremity. J Vasc Surg 2001; 33: 375-8.

  10. Rojas GA, Cervantes J, Ponte R, Ramírez S, García M. Interrupción de vena cava diez años de experiencia en el Hospital American British Cowdray. Cir Ciruj 1999; 67: 17-21.

  11. Greenfield LJ. Recommended reporting standards for vena caval filter placement and patient follow-up. J Vasc Surg 1999; 30: 573-9.

  12. Gupta S, Ettles DF, Robinson GJ, Lindowa SW. Inferior vena cava filter use in pregnancy. Preliminary experience: British Journal of Obstetrics and Gynaecology. BJOG 2008; 115: 785-8.

  13. Kawamata K, Chiba Y, Tanaka R, Higashi M, Nishigami K. Experience of temporary inferior vena cava filters inserted in the perinatal period to prevent pulmonary embolism in pregnant women with deep vein trombosis. J Vasc Surg 2005; 41: 652-6.

  14. McConville RM, Kennedy PT, Collins AJ, Ellis PK. Failed retrieval of an inferior vena cava filter during pregnancy because of filter tilt. Report of two cases. Cardiovasc Intervent Radiol 2009; 32: 174-7.

  15. Greenfield LJ, Proctor MC. Recurrent thromboembolism in patients with vena cava filters. J Vasc Surg 2001; 33: 510-4.

  16. Greenfield LJ, Proctor MC. Suprarrenal filter placement. J Vasc Surg 1998; 28: 432-8.




2020     |     www.medigraphic.com