scholarly journals Cerebral Venous Thrombosis after a Cesarean Delivery

2010 ◽  
Vol 53 (2) ◽  
pp. 109-113 ◽  
Author(s):  
Edvard Ehler ◽  
Aleš Kopal ◽  
Milan Mrklovský ◽  
Milan Košťál
Keyword(s):  
Risk Factors ◽  
Molecular Weight ◽  
Venous Thrombosis ◽  
Cesarean Delivery ◽  
Cerebral Venous Thrombosis ◽  
Low Molecular Weight Heparin ◽  
Methylenetetrahydrofolate Reductase ◽  
Low Molecular Weight ◽  
Viii Level ◽  
Risk Patients

Cerebral venous thrombosis (CVT) is a serious condition affecting mostly women. This report concerns two cases of women who developed CVT within 14 days of cesarean delivery. Magnetic resonance angiography of the brain (venous phase) is the best modality to diagnose the condition, and parenteral application of low-molecular-weight heparin is the most beneficial treatment. The first patient was found to have an elevated factor VIII level. In the second patient, homozygosity of the C677T mutation in the 5,10-methylenetetrahydrofolate reductase gene was found. The puerperal period and Cesarean Section (CS) are risk factors for thrombotic complications, including CVT. It is necessary to search for risk factors in a patient’s history and within the group of at-risk patients to prolong preventive administration of low molecular weight heparin (LMWH). CVT (including puerperium related) is not a detrimental to future pregnancies.

scholarly journals Unfractionated or Low–Molecular Weight Heparin for the Treatment of Cerebral Venous Thrombosis

Stroke ◽  
2010 ◽  
Vol 41 (11) ◽  
pp. 2575-2580 ◽  
Author(s):  
Jonathan M. Coutinho ◽  
José M. Ferro ◽  
Patrícia Canhão ◽  
Fernando Barinagarrementeria ◽  
Marie-Germaine Bousser ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Low Molecular Weight Heparin ◽  
Low Molecular Weight

scholarly journals Evaluation and Management of Women who Have Experienced Stillbirth in Their Previous Pregnancies

2019 ◽  
pp. 1
Author(s):  
Erdem Fadiloglu ◽  
Atakan Tanacan ◽  
Canan Unal ◽  
Mehmet Sinan Beksac
Keyword(s):  
Risk Factors ◽  
Molecular Weight ◽  
Low Molecular Weight Heparin ◽  
Low Dose ◽  
Methylenetetrahydrofolate Reductase ◽  
Post Partum ◽  
Subsequent Pregnancy ◽  
Low Molecular Weight ◽  
Mthfr Polymorphisms ◽  
The Mean

<p><strong>Objective:</strong> To evaluate the subsequent pregnancy outcomes of women who have experienced unexplained stillbirth in their previous gestations.</p><p><strong>Study Design:</strong> This retrospective cohort consisted of 14 pregnancies who had stillbirth (without known risk factors) in their previous pregnancies. These patients had been included in a special preconceptional care program to be evaluated in terms of etiological risk factors for stillbirth. At least one of the risk factors, such as methylenetetrahydrofolate reductase (MTHFR) polymorphisms, hereditary thrombophilias and autoimmune problems, were defined in this study population. After detection of pregnancy, the patients were administered low-dose low-molecular-weight heparin (LMWH) (enoxaparin, 1×2000 Anti-XA IU/0.2 mL/day), low-dose salicylic acid (100 mg/day) and low-dose corticosteroid (methylprednisolone, 1×4 mg/day orally) in necessary cases.</p><p><strong>Results:</strong> Out of 14 pregnancies, 4 (28.5%) ended up with miscarriages at 9, 11, 11 and 15 gestational weeks, respectively. The remaining 10 pregnancies ended up with alive deliveries. The mean gestational week at birth was 36.4±0.51, while the mean birthweight was 2882±381.01 g. Out of 10 pregnancies, only one was diagnosed as IUGR. Only two newborn necessitated hospitalization in the neonatal intensive care unit (NICU) due to respiratory problems. Both newborns were discharged from the NICU without any further complication at the post-partum 5th day. </p><p><strong>Conclusion:</strong> Patients with a prior stillbirth should be screened for MTHFR polymorphisms, autoimmune problems and hereditary thrombophilias, especially in case of absence of any etiological factor. Management of these patients with low-dose aspirin, low-dose low molecular weight heparin and corticosteroids seemed to be beneficial for increasing live birth rates and avoiding obstetric complications.</p>

scholarly journals Cerebral venous thrombosis: An experience with anticoagulation with low molecular weight heparin

2005 ◽  
Vol 9 (1) ◽  
pp. 14-18 ◽  
Author(s):  
Lalitha V. Pillai ◽  
Dhananjay P. Ambike ◽  
Satish Nirhale ◽  
S. M. K. Husainy ◽  
Satish Pataskar
Keyword(s):  
Molecular Weight ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Low Molecular Weight Heparin ◽  
Low Molecular Weight

scholarly journals Antithrombotic Strategy in Cerebral Venous Thrombosis: Differences Between Neurologist and Hematologist Respondents in a Canadian Survey

2016 ◽  
Vol 44 (1) ◽  
pp. 116-119 ◽  
Author(s):  
Thalia S. Field ◽  
Marie-Christine Camden ◽  
Sohaila Al-Shimemeri ◽  
Gary Lui ◽  
Agnes Y.Y. Lee
Keyword(s):  
Molecular Weight ◽  
Venous Thrombosis ◽  
Unfractionated Heparin ◽  
Cerebral Venous Thrombosis ◽  
Low Molecular Weight Heparin ◽  
Response Rate ◽  
Low Molecular Weight ◽  
Clinical Equipoise ◽  
First Line ◽  
Patterns Of Practice

AbstractPatterns of practice for management of cerebral venous thrombosis in Canada are unknown. We surveyed Canadian neurologists and hematologists regarding anticoagulation in cerebral venous thrombosis. The response rate was 28%, with 27 neurologists and 20 hematologists responding. We found that choice of first-line initial anticoagulation differed significantly between neurologists and hematologists, with 89% of neurologists favouring unfractionated heparin and hematologists’ preference split between unfractionated heparin (50%) and low-molecular-weight heparin (50%). Differences in patterns of practice likely reflect clinical equipoise.

Thromboprophylaxis with low-molecular-weight heparin after cesarean delivery

2010 ◽  
Vol 103 (01) ◽  
pp. 129-137 ◽  
Author(s):  
Arnaud Perrier ◽  
Mathieu Nendaz ◽  
Marc Righini ◽  
Francoise Boehlen ◽  
Michel Boulvain ◽  
...  
Keyword(s):  
Risk Factors ◽  
Molecular Weight ◽  
Life Expectancy ◽  
Cesarean Delivery ◽  
Low Molecular Weight Heparin ◽  
Developed Countries ◽  
Sensitivity Analyses ◽  
Low Molecular Weight ◽  
Level Of Evidence ◽  
Quality Adjusted Life

SummaryAlthough venous thromboembolism (VTE) is the leading cause of maternal mortality in developed countries, the usefulness of preventive low-molecular-weight heparin (LMWH) after cesarean delivery remains a matter of controversy. It was the objective of this study to evaluate the usefulness of thromboprophylaxis with LMWH after cesarean delivery. A decision model was constructed to evaluate the risks and benefits associated with a seven-day LMWH prophylaxis, compared with none. All probabilities were obtained from literature according to the highest level of evidence. We performed our analysis on two different sets of outcomes (utilities and disutilities), to calculate the quality-adjusted life expectancy at three months. Finally, we calculated the outcomes for four hypothetical cases with different risk. Prophylaxis with LMWH yielded the highest quality-adjusted life expectancy, with a net gain of 1.5–2.8 quality-adjusted days. Sensitivity analyses showed the incidence of VTE after cesarean delivery and the haemorrhagic risk related to LMWH to be critical, at threshold values of 0.15–0.22% and 0.23–0.35%, respectively. In the hypothetical cases, LMWH was safe but only marginally more effective in women with no risk factors. In case of an emergency procedure, a body-mass index >25kg/m2, tobacco smoking, or any combination of these, reductions in VTE greatly outnumbered the increase in major haemorrhages, with a modest benefit on mortality. Our decision analysis suggests that the benefits of LMWH after cesarean delivery exceed the risks. This benefit is, however, very low in women with no risk factors.

scholarly journals Cerebral venous thrombosis in women of childbearing age: diagnosis, treatment, and prophylaxis during a future pregnancy

2020 ◽  
Vol 13 ◽  
pp. 175628642094516
Author(s):  
Büșra Durmuș ◽  
Laetitia Yperzeele ◽  
Susanna M Zuurbier
Keyword(s):  
Molecular Weight ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Low Molecular Weight Heparin ◽  
Hormone Replacement ◽  
Thrombosis Prophylaxis ◽  
Low Molecular Weight ◽  
Optimal Dosage ◽  
Childbearing Age ◽  
History Of

Sex-specific risk factors for cerebral venous thrombosis (CVT) in women include oral contraceptives, pregnancy, puerperium, and hormone replacement therapy. The acute treatment of CVT is anticoagulation using therapeutic doses of low molecular weight heparin, which is also the preferred treatment in the post-acute phase in pregnancy and during breastfeeding. In patients with imminent brain herniation decompressive surgery is probably life-saving. A medical history of CVT alone is not a contraindication for future pregnancies. The optimal dosage of low molecular weight heparin as thrombosis prophylaxis during future pregnancies after a history of venous thrombosis including CVT is the topic of an ongoing trial.

scholarly journals Early incidence of deep venous thrombosis and its early marker after knee arthroscopy: A retrospective study with routinely applied ultrasonography

2020 ◽  
Author(s):  
Lei Shu ◽  
Qubo Ni ◽  
Biao Chen ◽  
Hangyuan He ◽  
Liaobin Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Molecular Weight ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Low Molecular Weight Heparin ◽  
Knee Arthroscopy ◽  
Multiple Logistic Regression Analysis ◽  
Low Molecular Weight ◽  
Early Marker ◽  
D Dimer

Abstract Background: To (1) investigate the early incidence of deep venous thrombosis (DVT) after knee arthroscopy at a single institution and (2) determine the early marker for DVT in these patients.Methods: The records of patients who underwent knee arthroscopy in our department between January 2018 and October 2019 were reviewed. Ultrasonography was performed for each patient at 24h preoperative and 72h postoperative. The low-molecular-weight-heparin (LMWH) was routinely used as thromboprophylaxis on the first day postoperative after 1st January 2019. Preoperative and perioperative data were collected with respect to demographic data, medical history, medications, and surgical and anesthesia data. Chi-square test or Student t test was used to preliminarily screen out suspected risk factors. Then, multiple logistic regression analysis was utilized to further determine the risk factors of DVT after knee arthroscopy.Results: During the study period, 272 patients were reviewed. Among these patients, 21 cases of DVT occurred, resulting in an incidence of 7.7%, two (0.74%) of which were identified as symptomatic thrombosis. The incidence of DVT in the anticoagulant group was 7.9%, and 7.4% in the non-anticoagulant group, respectively. The use of low molecular weight heparin postoperative did not reduce the incidence of DVT after knee arthroscopy. An increased D-dimer level could be an early marker for an elevated risk of postoperative DVT. No association between different arthroscopic procedures and thrombotic events. And the tourniquet time are not related risk factor.Conclusions: In this study, the early incidence of DVT after knee arthroscopy was 7.7%. Symptomatic DVT was rare and occurred infrequently. The incidence of DVT within three days could not be reduced by using LMWH, and a high D-dimer level was an early marker for DVT after knee arthroscopy.

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