[Venous thromboembolism during pregnancy].
Pulmonary embolism is one of the most common cause of maternal death in developed countries. Pregnancy is associated with a hypercoagulable state, increased especially in patients with thrombophilia. The post-partum period is the period carrying the highest risk of venous thromboembolism, especially after caesarean delivery. The diagnosis is essential, applying strategies validated in the non-pregnant population, as none of the diagnostic tests is contra-indicated during pregnancy. These strategies use a combination of empirical evaluation of clinical probability, D-Dimer measurement. In case of positive D-Dimer testing (or high clinical probability), ultrasonography of the legs should be performed first; if there is no proximal deep vein thrombosis, pulmonary CT scan or lung scan should be performed. Low molecular weight heparin is the treatment of choice until 6 weeks after the delivery, for a minimal total duration of 6 months. The prophylaxis must be individually decided according to histories and risk factors of the patient.
Florence
F
Parent
Roland
R
Jovan
Veronique
V
Colas des Francs
D000925:Anticoagulants / Q000627:therapeutic use; D003663:Decision Trees; D003952:Diagnostic Imaging; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006801:Humans; D011247:Pregnancy / Q000097:blood; D011250:Pregnancy Complications, Hematologic / Q000175:diagnosis* / Q000188:drug therapy; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000517:prevention & control; D054556:Venous Thromboembolism / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy
D000925:Anticoagulants; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D