关注妊娠期静脉血栓栓塞症

肺血栓栓塞症(PTE)和深静脉血栓形成(DVT)合称为静脉血栓栓塞症(VTE)。妊娠期女性由于存在高凝状态、静脉淤滞、血管损伤等特殊的生理变化,VTE发生风险增高。对存在VTE症状或体征的孕产妇,除非存在明确的抗凝禁忌,否则均应尽快行客观检查同时给予抗凝治疗直到完全排除VTE诊断。低分子肝素(LMWH)不通过胎盘,且无哺乳禁忌,是妊娠及产褥期VTE患者抗凝治疗的最佳选择。一旦开始LMWH初始治疗,应该在余下孕程持续使用,直到产后6周,且总疗程不少于3个月。

Focus on venous thromboembolism during pregnancy

Venous thromboembolism (VTE) is constituted by pulmonary thromboembolism (PTE) and deep venous thrombosis (DVT). Blood hypercoagulable, along with vascular damage and stasis during pregnancy and puerperium contribute to a high incidence of VTE. In clinically suspected VTE, anticoagulation therapy should be commenced immediately until the diagnosis is excluded by objective testing, unless treatment is strongly contraindicated. Low molecular weight heparin (LMWH) does not pass through the placenta and is safe in breastfeeding, hence will be the best choice for pregnancy and puerperium. Treatment with LMWH should be employed during the remainder of the pregnancy and last for at least 6 weeks postnatally and at least 3 months of treatment will be necessary.