[Antithrombotic agents in pregnancy].
The need for antithrombotic therapy during pregnancy is a challenging problem for the clinician. Pregnancy per se is associated with a prothrombotic state, and some conditions definitely require anticoagulant treatment. However, all three main antithrombotic agents (coumarins, heparin and aspirin) have potential serious adverse effects for the mother and fetus. The aim of this review was to discuss the modifications of the coagulation system during pregnancy, and try to properly state the indications and the best schedule of antithrombotic treatment during pregnancy. Presently heparin is considered the anticoagulant of choice for the treatment and prevention of venous thromboembolic disorders and in patients with congenital or acquired thrombophilic conditions. The use of oral anticoagulants is still preferred in women with prosthetic heart valves or atrial fibrillation, but they cannot be administered between the sixth and twelfth week and in the last month of gestation because of the teratogenic and hemorrhagic risks related to their use. Low-dose aspirin is useful for the prevention of pre-eclampsia, intrauterin growth retardation, and in association with heparin or prednisone, for the prevention of abortion in patients with antiphospholipid antibodies.
Gensini
G F
GF
Istituto di Clinica Medica I e Cardiologia, Università degli Studi, Firenze.
Comeglio
M
M
Abbate
R
R
D017152:Antibodies, Antiphospholipid / Q000097:blood; D005260:Female; D005315:Fetal Diseases / Q000139:chemically induced; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006350:Heart Valve Prosthesis; D006487:Hemostasis / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D011225:Pre-Eclampsia / Q000188:drug therapy; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood / Q000188:drug therapy*; D011655:Pulmonary Embolism / Q000188:drug therapy; D012307:Risk Factors; D013921:Thrombocytopenia / Q000139:chemically induced; D013923:Thromboembolism / Q000188:drug therapy; D013924:Thrombophlebitis / Q000188:drug therapy
D017152:Antibodies, Antiphospholipid; D005343:Fibrinolytic Agents
I farmaci antitrombotici in gravidanza.