Management of pregnant women with increased risk of venous thrombosis.
OBJECTIVE
To evaluate the usefulness of score based management of pregnancies with high risk of venous thromboembolism (VTE).


METHODS
116 consecutive pregnancies in 109 women with confirmed thrombophilia and/or history of VTE were studied. Patients were managed in accordance with international recommendations. Recently, a VTE risk prediction score was established. An independent group assessed retrospectively and in a blinded way the usefulness of this score.


RESULTS
Of the 116 pregnancies, an antithrombotic prophylaxis by low molecular weight heparin was prescribed in 61 cases (52.6%). All patients with a positive score (n=57, 49.1%) have been treated with an antenatal thromboprophylaxis. In the population where the score was negative (n=55 cases), none of the patients received antenatal prophylaxis. But, despite a negative score, four patients were treated by their general practitioner. During the study period, there was only one episode of VTE.


CONCLUSIONS
Implementing this scoring system has resulted in favorable outcomes and a low risk of recurrent thrombosis in this limited series of women with increased risk of VTE.
Dargaud
Y
Y
Laboratoire d'Hémostase et Unité d'Hémostase Clinique, Hôpital Edouard Herriot, Lyon, France. ydargaud@univ-lyon1.fr
Rugeri
L
L
Ninet
J
J
Negrier
C
C
Trzeciak
M C
MC
D000328:Adult; D003661:Decision Support Techniques; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008499:Medical Records; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000473:pathology / Q000517:prevention & control*; D018566:Pregnancy, High-Risk; D011295:Prenatal Care; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020246:Venous Thrombosis / Q000473:pathology / Q000517:prevention & control*
D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight