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中华产科急救电子杂志 ›› 2023, Vol. 12 ›› Issue (02) : 81 -84. doi: 10.3877/cma.j.issn.2095-3259.2023.02.004

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易栓症在围分娩期的临床管理
呼延凌越, 乔宠()   
  1. 110004 沈阳,中国医科大学附属盛京医院妇产科
  • 收稿日期:2022-10-12 出版日期:2023-05-18
  • 通信作者: 乔宠
  • 基金资助:
    国家重点研发计划资助(2016YFC1000404); 国家自然基金面上项目(81370735); 国家自然科学基金面上项目(81771610); 沈阳市科技计划项目(20-205-4-004); 辽宁省民生科技计划联合计划项目(2021JH2/10300123); 百千万人才工程领军人才(XLYC2005008)

Clinical management of thrombophilia in peripartum

Lingyue Huyan, Chong Qiao()   

  • Received:2022-10-12 Published:2023-05-18
  • Corresponding author: Chong Qiao
引用本文:

呼延凌越, 乔宠. 易栓症在围分娩期的临床管理[J]. 中华产科急救电子杂志, 2023, 12(02): 81-84.

Lingyue Huyan, Chong Qiao. Clinical management of thrombophilia in peripartum[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2023, 12(02): 81-84.

易栓症是遗传性凝血因子异常或获得性血栓高危因素所导致的一类血栓高危疾病。妊娠期的易栓症不仅会增加血栓事件发生的风险,还与不良妊娠结局相关。易栓症导致的血栓栓塞主要为静脉血栓栓塞,主要发生于产前和产后6周,因此,科学、系统的围产期临床管理对于易栓症患者降低血栓风险具有重大意义。

Thrombophilia is a series of high-risk diseases of thrombosis caused by abnormal hereditary coagulation factors or acquired high risk factors of thrombosis. Thrombophilia in pregnancy not only increases the risk of thrombotic events, but also is associated with adverse pregnancy outcomes. Thromboembolism caused by thrombophilia is mainly venous thromboembolism, which mainly occurs before and six weeks after delivery. Therefore, scientific and systematic peripartum clinical management is of great significance for thrombophilia patients to reduce the risk of thrombosis.

[1]
Abildgaard U. Olav Egeberg--hereditary antithrombin deficiency and thrombophilia[J]. Tidsskr Nor Laegeforen2001121(5):604-605.
[2]
Tang L, Hu Y. Ethnic diversity in the genetics of venous thromboembolism[J]. Thromb Haemost2015114(5):901-909.
[3]
Bartlett MA, Mauck KF, Stephenson CR, et al. Perioperative Venous thromboembolism prophylaxis[J]. Mayo Clin Proc202095(12):2775-2798.
[4]
Hart C, Bauersachs R, Scholz U, et al. Prevention of venous thromboembolism during pregnancy and the puerperium with a special focus on women with hereditary thrombophilia or prior VTE-position paper of the Working Group in Women′s Health of the Society of Thrombosis and Haemostasis (GTH)[J]. Hamostaseologie202040(5):572-590.
[5]
Heit JA, Kobbervig CE, James AH, et al. Trends in the incidence of venous thromboembolism during pregnancy or postpartum: a 30-year population-based study[J]. Ann Intern Med2005143(10):697-706.
[6]
Ray JG, Chan WS. Deep vein thrombosis during pregnancy and the puerperium: a meta-analysis of the period of risk and the leg of presentation[J]. Obstet Gynecol Surv199954(4):265-271.
[7]
Pomp ER, Lenselink AM, Rosendaal FR, et al. Pregnancy, the postpartum period and prothrombotic defects: risk of venous thrombosis in the MEGA study[J]. J Thromb Haemost20086(4):632-637.
[8]
James AH, Jamison MG, Brancazio LR, et al. Venous thromboembolism during pregnancy and the postpartum period: incidence, risk factors, and mortality[J]. Am J Obstet Gynecol2006194(5):1311-1315.
[9]
Simpson EL, Lawrenson RA, Nightingale AL, et al. Venous thromboembolism in pregnancy and the puerperium: incidence and additional risk factors from a London perinatal database[J]. BJOG2001108(1):56-60.
[10]
Benedetto C, Marozio L, Tavella AM, et al. Coagulation disorders in pregnancy: acquired and inherited thrombophilias[J]. Ann N Y Acad Sci20101205:106-117.
[11]
Jacobsen AF, Skjeldestad FE, Sandset PM. Incidence and risk patterns of venous thromboembolism in pregnancy and puerperium--a register-based case-control study[J]. Am J Obstet Gynecol2008198(2):233.e1-233.e7.
[12]
Kamel H, Navi BB, Sriram N, et al. Risk of a thrombotic event after the 6-week postpartum period[J]. N Engl J Med2014370(14):1307-1315.
[13]
Simcox LE, Ormesher L, Tower C, et al. Thrombophilia and pregnancy complications[J]. Int J Mol Sci201516(12):28418-28428.
[14]
Dugalic S, Petronijevic M, Stefanovic A, et al. Comparison of 2 approaches in management of pregnant women with inherited trombophilias: prospective analytical cohort study[J]. Medicine (Baltimore)201998(34):1-7.
[15]
American College of Obstetricians and Gynecologists′ Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 197: Inherited thrombophilias in pregnancy[J]. Obstet Gynecol2018132(1):e18-e34.
[16]
Royal College of Obstetricians and Gynaecologists. Reducing the risk of venous thromboembolism during pregnancy and the puerperium. Green-top Guideline No.37a[EB/OL].(2015-04-13)[2022-10-12].

URL    
[17]
中华医学会血液学分会血栓与止血学组. 易栓症诊断与防治中国指南(2021年版)[J]. 中华血液学杂志202142(11):881-888.
[18]
上海市母婴安全专家委员会,上海市医学会围产医学专科分会,上海市医学会妇产科专科分会产科学组,等. 上海市产科静脉血栓栓塞症防治的专家共识[J]. 上海医学202043(11):645-650.
[19]
Chan WS, Rey E, Kent NE, et al. Venous thromboembolism and antithrombotic therapy in pregnancy[J]. J Obstet Gynaecol Can201436(6):527-553.
[20]
Bates SM, Greer IA, Middeldorp S, et al. VTE, thrombophilia, antithrombotic therapy, and pregnancy: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines[J]. Chest2012141(2 Suppl):e691S-e736S.
[21]
Aumüller G, Hartley-Asp B, Seitz J. Differential reaction of secretory and non-secretory proteins in hormone-treated Dunning tumor[J]. Prostate198915(2):81-94.
[22]
Bonnar J, Green R, Norris L. Perinatal aspects of inherited thrombophilia[J]. Semin Thromb Hemost199925(5):481-485.
[23]
Bates SM, Middeldorp S, Rodger M, et al. Guidance for the treatment and prevention of obstetric-associated venous thromboembolism[J]. J Thromb Thrombolysis201641(1):92-128.
[24]
Empson M, Lassere M, Craig J, et al. Prevention of recurrent miscarriage for women with antiphospholipid antibody or lupus anticoagulant[J]. Cochrane Database Syst Rev20052005(2):1-60.
[25]
Garcia D, Erkan D. Diagnosis and management of the antiphospholipid syndrome[J]. N Engl J Med2018378(21):2010-2021.
[26]
Committee on Practice Bulletins—Obstetrics, American College of Obstetricians and Gynecologists. Practice Bulletin No.132: antiphospholipid syndrome[J]. Obstet Gynecol2012120(6):1514-1521.
[27]
Ginsberg JS, Greer I, Hirsh J. Use of antithrombotic agents during pregnancy[J]. Chest2001119(1 Suppl):122S-131S.
[28]
Lepercq J, Conard J, Borel-Derlon A, et al. Venous thromboembolism during pregnancy: a retrospective study of enoxaparin safety in 624 pregnancies[J]. BJOG2001108(11):1134-1140.
[29]
Giannubilo SR, Tranquilli AL. Anticoagulant therapy during pregnancy for maternal and fetal acquired and inherited thrombophilia[J]. Curr Med Chem201219(27):4562-4571.
[30]
Horlocker TT, Wedel DJ, Rowlingson JC, et al. Executive summary: regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Third Edition)[J]. Reg Anesth Pain Med201035(1):102-105.
[31]
Leffert L, Butwick A, Carvalho B, et al. The Society for Obstetric Anesthesia and Perinatology consensus statement on the anesthetic management of pregnant and postpartum women receiving thromboprophylaxis or higher dose anticoagulants[J]. Anesth Analg2018126(3):928-944.
[32]
Freedman RA, Bauer KA, Neuberg DS, et al. Timing of postpartum enoxaparin administration and severe postpartum hemorrhage[J]. Blood Coagul Fibrinolysis200819(1):55-59.
[33]
王丹,阎萍. 剖宫产术后的抗凝治疗[J]. 中华产科急救电子杂志[J/OL]20198(4):215-219.
[34]
汪宇纾,孙熙木,高红,等. 妊娠期和产褥期相关静脉血栓栓塞症防治指南及共识质量评价和内容比较[J]. 中国实用妇科与产科杂志202238(12):1224-1230.
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