Women are at increased risk for venous thromboembolism (VTE) during both pregnancy and in the post-partum period. We have conducted a comprehensive literature review of the use of anticoagulation in pregnancy for pregnant women at increased risk for VTE. Multiple factors, including physiologic and pharmacokinetic changes make the treatment and prevention of VTE complicated in pregnancy. Adequate treatment and prevention of VTE in pregnancy is critically important, yet good quality medical studies continue to be lacking. There is a growing amount of data for the use of low molecular weight heparin (LMWH) in pregnant women and this remains the treatment of choice in most indications. For both prophylactic and therapeutic treatments, when LMWHs are chosen, monitoring of antifactor Xa level, although controversial, is advised. Women with prosthetic valve who become pregnant face challenges in regard of type of anticoagulation, dosing and monitoring during pregnancy. Delivery options and peripartum care should be defined with a multidisciplinary approach and taking patient's preference and autonomy in consideration. More high-quality research on this topic is needed to guide the clinical care of this unique population.
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http://dx.doi.org/10.23736/S0026-4784.18.04341-1 | DOI Listing |
Obstet Gynecol
January 2025
University of Utah Health, Salt Lake City, Utah; Inova Health, Vienna, and Eastern Virginia Medical School, Norfolk, Virginia; University of Texas Medical Branch, Galveston, Texas; University of Alabama at Birmingham, Birmingham, Alabama; and Denver Health and Hospital Authority, Denver, Colorado.
Objective: To evaluate the effect of administering postpartum heparin-based pharmacologic thromboprophylaxis on the incidence of postpartum venous thromboembolism (VTE) and complications.
Methods: This was a multicenter retrospective cohort study of all individuals delivering at more than 20 weeks of gestation at four U.S.
J Matern Fetal Neonatal Med
December 2025
Department of Vascular Surgery & Interventional Therapy, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
Background: Pregnancy-associated venous thromboembolism (PA-VTE) seriously threatens maternal health. We aimed to investigate the clinical characteristics, risk factors, treatments, and pregnancy outcomes to better prevent and treat PA-VTE.
Methods: PA-VTE patients were selected from 171,898 women who were registered in the Department of Obstetrics of Fujian Maternity and Child Health Hospital from January 2014 to August 2023 and delivered to calculate the incidence.
J Stroke Cerebrovasc Dis
January 2025
Department of Neurology, University of Iowa College of Medicine; Department of Epidemiology, University of Iowa College of Public Health; Department of Neurosurgery, University of Iowa College of Medicine.
Antiphospholipid syndrome is an autoimmune disease characterised by thrombotic and/or obstetric manifestations with persistent antiphospholipid antibodies. Diagnosis involves confirming the persistence of antiphospholipid antibodies in symptomatic patients, using validated classification criteria as a guide. The likelihood of obtaining false-positive or false-negative test results in certain settings, and the lack of standardisation between laboratory methods, are important considerations.
View Article and Find Full Text PDFInt J Mol Sci
December 2024
Department of Obstetrics and Gynecology, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Pregnancy complications associated with thrombophilia represent significant risks for maternal and fetal health, leading to adverse outcomes such as pre-eclampsia, recurrent pregnancy loss, and intra-uterine growth restriction (IUGR). They are caused by disruptions in key physiological processes, including the coagulation cascade, trophoblast invasion, angiogenesis, and immune control. Recent advancements in epigenetics have revealed that non-coding RNAs, especially microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and extracellular vesicles (EVs) carrying these RNAs, play crucial roles in the regulation of these biological processes.
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