Thromboembolic disorders in pregnancy

2016 ◽  
Author(s):  
Salma Ballal ◽  
Ian A. Greer
Keyword(s):  
Risk Factors ◽  
Low Molecular Weight Heparin ◽  
Pregnant Patient ◽  
Western World ◽  
Low Molecular Weight ◽  
Vein Thrombosis ◽  
History Of ◽  
Problem Awareness ◽  
Deep Vein ◽  
In Pregnancy

Thromboembolism in pregnancy remains a major cause of direct maternal mortality in the Western world. Thromboembolic events in pregnancy are spread across the three trimesters but the puerperium is the time of greatest risk with a relative risk of around 20-fold compared to the non-pregnant patient. When compared to the non-pregnant population where distal deep vein thrombosis is most common, most events in pregnancy are iliofemoral and left sided. Given the multi-hit nature of the problem, awareness of risk factors is important. The two most significant single risk factors in pregnancy for thromboembolism are history of previous venous thromboembolism and thrombophilia. The identification of risk factors will guide the use of thromboprophylaxis and assist diagnosis; however, objective diagnosis is required. Prophylaxis and treatment focuses on low-molecular-weight heparin, which is considered safe in pregnancy.

scholarly journals Risk factors for deep vein thrombosis even using low-molecular-weight heparin after total knee arthroplasty

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Joon Kyu Lee ◽  
Kee Byoung Lee ◽  
Joong Il Kim ◽  
Gun Tae Park ◽  
Young Chang Cho
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Molecular Weight ◽  
Total Knee Arthroplasty ◽  
Low Molecular Weight Heparin ◽  
Low Molecular Weight ◽  
Vein Thrombosis ◽  
Total Knee ◽  
Deep Vein ◽  
Significant Factors

Abstract Background With an increase in deep vein thrombosis (DVT) following total knee arthroplasty (TKA) in the Asian population, most surgeons today use a form of prophylactic anticoagulant agents in patients after TKA. Nevertheless, DVT occasionally develops even in these patients with prophylaxis. The purpose of this study was to identify the risk factors for DVT after TKA in cases of postoperative low-molecular-weight heparin (LMWH) use. Methods We designed a retrospective study with 103 patients who underwent primary TKA. From the second postoperative day, 60 mg of LMWH was subcutaneously injected into the patients daily. On the seventh postoperative day, patients had computed tomography angiography to check whether they had DVT. Regarding risk factors, we investigated patients’ gender, age, surgical site (unilateral/bilateral), body mass index, method of anesthesia, preoperative hypertension, diabetes, hypercholesterolemia status, and prothrombin time/international normalized ratio from electronic medical records. We analyzed the statistical significance of these risk factors. Results Statistically significant factors in the single-variable analysis were surgical site (unilateral/bilateral), body mass index, preoperative hypertension status, and anesthesia method. Multiple logistic regression analysis with these factors revealed that the surgical site (unilateral/bilateral, p = 0.024) and anesthesia method (p = 0.039) were significant factors for the occurrence of postoperative DVT after TKA. Conclusions Patients undergoing simultaneous bilateral TKAs and patients undergoing TKA with general anesthesia need more attention regarding DVT even with chemoprophylaxis using LMWH after TKA.

Risk Factors for Deep Vein Thrombosis in Pregnancy and Puerperium at a Tertiary Care Hospital in Muzaffarabad, AJK

2021 ◽  
Vol 15 (12) ◽  
pp. 3191-3192
Author(s):  
Mudasar Hafiz ◽  
Muanzza Nazir ◽  
Syeda Abida Hussain ◽  
Rubina Rafique ◽  
Nosheena Shabir ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Deep Vein Thrombosis ◽  
Gestational Diabetes ◽  
Past History ◽  
Third Trimester ◽  
Vein Thrombosis ◽  
History Of ◽  
Deep Vein ◽  
In Pregnancy

Aim: Risk factors of deep vein thrombosis in pregnancy and puerperium in our setting. Study Design: Descriptive Cross-sectional study Place and duration of study: Departments of Obs & Gynae and General Medicine, CMH Muzaffarabad, AJK from 20th December, 2019 to 20th June, 2020. Methodology: A total of 385 females were included. Demographic data including age, parity, gravidity, BMI, obesity and timing of DVT occurrence was noted. The associated risk factors including mode of delivery in postpartum women, smoking status, past history of DVT, gestational diabetes and Diabetes Mellitus were noted. Results: Mean age of the participants was 26.1±5.3 years. Frequency of women developing deep vein thrombosis during pregnancy was 84.9% and 15.1% women developed DVT during puerperium. Past history of DVT was present in 26.5%. 31.7% of women were known diabetics and 29.1% developed gestational diabetes during current pregnancy. Frequency of smoking was 4.2%. 8% women presented with DVT in first trimester, 139(36.1%) in second trimester and 154 (40%) in third trimester. Conclusion: DVT is more common in the third trimester of pregnancy than in puerperium. Obesity, Diabetes Mellitus and past history of DVT were significant risk factors identified in the study. Keywords: Pregnancy, Postpartum Period, Deep Vein Thrombosis

Comparison of a once Daily with a twice Daily Subcutaneous Low Molecular Weight Heparin Regimen in the Treatment of Deep Vein Thrombosis

1998 ◽  
Vol 79 (05) ◽  
pp. 897-901 ◽  
Author(s):  
Bernard A. Charbonnier ◽  
Jean-Noël Fiessinger ◽  
J. D. Banga ◽  
Ernst Wenzel ◽  
Pascal d’Azemar ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Low Molecular Weight Heparin ◽  
Low Molecular Weight ◽  
Daily Regimen ◽  
Once Daily ◽  
Daily Group ◽  
Vein Thrombosis ◽  
Deep Vein

SummaryBackground: Clinical trials have been performed to compare with standard heparin a once or a twice daily regimen of low-molecular-weight heparin but no direct comparison has been done between these two low-molecular-weight heparin regimens in terms of efficacy and safety with a long-term clinical evaluation.Methods: Patients with proximal deep vein thrombosis, confirmed by venography were randomly assigned to either nadroparin (10,250 AXa IU/ml) twice daily or nadroparin (20,500 AXa IU/ml) once daily for at least 5 days. Regimens were adjusted to bodyweight. Oral anticoagulants were started on day 1 or 2 and continued for 3 months. Patients were followed up for 3 months. The composite outcome of venous thromboembolism and death possibly related to pulmonary embolism was the primary measure of efficacy. Major bleeding was the principal measure of safety. The study was designed to show equivalence between the two regimens.Results: Recurrent thromboembolic events or death possibly related to pulmonary embolism were reported in 13 patients in the once daily group (4.1%) and in 24 patients of the twice daily group (7.2%): (absolute difference 3.1% in favor of the once daily regimen; 95% confidence interval -6.6%, +0.5%). Major bleeding episodes during nadroparin treatment occurred in 4 (1.3%) and 4 patients (1.2%) in the once and twice daily groups, respectively.Conclusions: A nadroparin regimen of one injection per day is at least as effective and safe as the same total daily dose divided over two injections for the treatment of acute deep vein thrombosis.

scholarly journals Combination of Traditional Chinese Medicine and Low-Molecular-Weight Heparin Prevents Deep Vein Thrombosis After Surgery: A Meta-Analysis

2019 ◽  
Vol 25 ◽  
pp. 107602961989041
Author(s):  
Chu Chen ◽  
Qing Tang ◽  
Wenjuan Zhang ◽  
Huijun Yuan ◽  
Ying Huai ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Deep Vein Thrombosis ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Low Molecular Weight Heparin ◽  
Mean Difference ◽  
Combination Group ◽  
Low Molecular Weight ◽  
Vein Thrombosis ◽  
Deep Vein

At present, there is no consistent understanding of the effect of traditional Chinese medicine (TCM) prescription in the prevention of the deep vein thrombosis (DVT), though TCM has been widely used in China. To evaluate the efficacy of TCM prescription combined with low-molecular-weight heparin (LMWH) for preventing DVT after major orthopedics surgery. All the retrieved articles were evaluated using specific inclusion and exclusion criteria. Then, data were extracted and evaluated for inclusion in a randomized controlled trial. In this study, variables included relative risk (RR), mean difference (MD), and their corresponding 95% confidence intervals (95% CIs). Overall, 16 articles were included with 1538 patients, 768 in the combination group (combination of TCM prescription and LMWH) and 770 in the LMWH group. The results indicated that in the combination group, the incidence of DVT (RR: 0.34, 95% CI: 0.23-0.50, P < .00001) and d-dimer levels (standardized mean difference: −1.19, 95% CI: −1.80 to −0.58, P = .0001) was significantly lower than that in the LMWH group. Furthermore, the combination treatment obviously decreased the concentration of fibrinogen (MD: −1.19, 95% CI: −2.13 to −0.25, P = .01). The combination of TCM prescription and LMWH could significantly reduce the incidence of DVT, suggesting that it may be a more effective prophylaxis measure for DVT after major orthopedics surgery.

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