[Venous thrombectomy in pregnancy. A follow-up study].
Deep venous thrombosis is an uncommon but feared complication in pregnancy. The treatment of choice in most centers is heparin and compression stockings, which effectively prevents pulmonary embolism, but the incidence of chronic venous insufficiency with skin change and ulcers after such treatment is reported to be up to 65%. In the period 1985-93, thirty-nine pregnant women were treated for femoroiliacal venous thrombosis (FIVT) with operative thrombectomy, arteriovenous fistula and anticoagulant therapy. The aim of this study was to examine those of the women who subsequently had been pregnant again. The pregnancy and delivery were closely monitored and the frequency of clinically detected as well as objectively measured venous insufficiency was recorded. Nineteen of the women subsequently became pregnant again, resulting in 25 deliveries. They were investigated at the Coagulation Laboratory and treated with phenendione or low molecularweight heparin. All pregnancies proceeded successfully. None showed clinical signs of rethrombosis during the subsequent pregnancy. At follow up 11 patients had dilated or varicose veins, nine had a closed iliaca at ultrasound examination, none had skin changes or ulcers. We conclude that women treated for FIVT in pregnancy with thrombectomy followed by anticoagulant therapy may undergo a new pregnancy with low risk of obstetrical complications and with a low risk of developing rethrombosis or chronic venous insufficiency.
Eriksen
L
L
Gynaekologisk obstetrisk afdeling, Amtssygehuset i Gentofte.
Pachler
J H
JH
D000925:Anticoagulants / Q000008:administration & dosage; D001458:Bandages; D005260:Female; D005268:Femoral Vein / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007084:Iliac Vein / Q000601:surgery*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy / Q000601:surgery*; D011256:Pregnancy Outcome; D017131:Thrombectomy; D020246:Venous Thrombosis / Q000188:drug therapy / Q000601:surgery*
D000925:Anticoagulants