[Prevention of deep vein thrombosis and preeclampsia. Therapeutic possibilities].
To prevent deep vein thrombosis during pregnancy and the puerperium, compression stockings and heparin have been proposed. These measures are safe for the mothers and their babies, however low molecular weight heparin (LMWH) must be preferred to unfractioned heparin if possible. The prevention of preeclampsia (PE) has been widely studied. Among nutrients, calcium supplementation is effective to prevent PE among women with a spontaneous low calcium intake, but fish oil supplementation is not. The effectiveness of folic acid is still controversial. Aspirin has been widely studied to prevent, and also treat, PE. The effectiveness of aspirin depends on an early administration during pregnancy and probably on the dose, while the best results have been observed with doses more than 60 mg/day. The association of aspirin and LMWH was used among patients with systemic pathologies, and no hemorrhagic complications were described. Oral anticoagulants are used only among patients with mechanical heart valves, the use between the 6th and the 12th week of pregnancy is controversial, because of an increased risk of fetal malformation, and near term because of an increased risk of neonatal hemorrhage.
Palot
Maryse
M
Département d'Anesthésie-Réanimation/DAR (Pr. Alain Léon), CHU, 51092 Reims Cedex. mpalot@chu-reims.fr
Daigremont-Botmans
Claire
C
Visseaux
Hugues
H
D001241:Aspirin / Q000627:therapeutic use; D002118:Calcium / Q000627:therapeutic use; D005260:Female; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011225:Pre-Eclampsia / Q000188:drug therapy / Q000517:prevention & control*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy / Q000517:prevention & control*; D020246:Venous Thrombosis / Q000188:drug therapy / Q000517:prevention & control*
D010975:Platelet Aggregation Inhibitors; D001241:Aspirin; D002118:Calcium