[Comprehensive treatment of ileofemoral thrombosis at the end of pregnancy with cesarean section in combination with thrombectomy].
Acute deep ileofemoral thrombosis was treated at the end of pregnancy in four pregnant women. A multidisciplinary approach was selected. During a single anaesthesia the team of obstetricians and neonatologists made a Caesarean section followed by thrombectomy with a Fogarty catheter. This operation was performed by a team of specialists in cardiovascular surgery. Two women developed rethrombosis: one woman on the following day, the second one two weeks after surgery. In both instances repeated thrombectomy was performed. In one woman the cause of ileofemoral thrombosis was malignant disease of the uterine cervix II and this woman is, after oncological treatment, in a serious condition due to the basis disease. The remaining three women were repeatedly subjected to phlebographic examinations and complete patency of the deep vascular system was found. These women are free from subjective and objective complaints and can look after their children. Pregnant women where a serious ileofemoral thrombosis was diagnosed had high fibrinogen and thrombocyte levels. In two women an AT III deficiency was found. There was also a high cholesterol level and positive antiphospholipid antibodies. Thrombectomy has according to the authors' experience very good results when the operation is implemented within 72 hours after initial symptoms. This procedure reduces the risk of chronic venous insufficiency.
Hájek
Z
Z
Gynek.-porod. klinika 1. LF UK a VFN, Praha.
Novotný
K
K
Drbohlav
P
P
Freitag
P
P
Kratochvíl
B
B
D000328:Adult; D002404:Catheterization; D002585:Cesarean Section; D005260:Female; D005268:Femoral Vein; D006801:Humans; D007084:Iliac Vein; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000175:diagnosis / Q000628:therapy*; D012008:Recurrence; D017131:Thrombectomy; D020246:Venous Thrombosis / Q000175:diagnosis / Q000628:therapy*