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《2011ACOG妊娠期遺傳性血栓癥臨床指南》內(nèi)容簡介:
Inherited thrombophilias are associated with an increased risk of venous thromboembolism and also have been linkedto adverse outcomes in pregnancy. However, there is limited evidence to guide screening for and management of theseconditions in pregnancy. The purpose of this document is to review common thrombophilias and their association withmaternal venous thromboembolism risk and adverse pregnancy outcomes, indications for screening to detect theseconditions, and management options in pregnancy.
《2011ACOG妊娠期遺傳性血栓癥臨床指南》內(nèi)容預覽:
Pregnancy is marked by increased clotting potential,decreased anticoagulant activity, and decreased fibrino-lysis . The thrombotic potential of pregnancy isexacerbated by venous stasis in the lower extremitiesdue to compression of the inferior vena cava and pel-vic veins by the enlarging uterus, a hormone-mediatedincrease in venous capacitance, insulin resistance, andhyperlipidemia. Thus, it is not surprising that venousthromboembolism complicates approximately 1 in 1,600births and is a leading cause of maternal morbidity in theUnited States .
There is a strong association between inherited throm-bophilias and venous thromboembolism, which makesdetection of these mutations a logical target for preventionstrategies (Table 1)。 However, it is controversial whetherthere is an association between inherited thrombophiliasand uteroplacental thrombosis that lead to adverse preg-nancy outcomes such as fetal loss, preeclampsia, fetalgrowth restriction, and placental abruption . This pos-sible association has resulted in increased screening forthrombophilias in pregnancy, although there has been noconfirmation of treatment benefits.
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