Pulmonary embolism in pregnancy

被引:208
作者
Bourjeily, Ghada [1 ]
Paidas, Michael [3 ]
Khalil, Hanan [2 ]
Rosene-Montella, Karen [1 ]
Rodger, Marc [4 ]
机构
[1] Brown Univ, Women & Infants Hosp Rhode Isl, Warren Alpert Med Sch, Dept Med, Providence, RI 02905 USA
[2] Brown Univ, Women & Infants Hosp Rhode Isl, Warren Alpert Med Sch, Dept Diagnost Imaging, Providence, RI 02905 USA
[3] Yale Univ, Sch Med, Yale New Haven Hosp, Dept Obstet Gynecol & Reprod Sci, New Haven, CT USA
[4] Univ Ottawa, Dept Med, Ottawa Hosp, Ottawa, ON, Canada
关键词
MOLECULAR-WEIGHT HEPARIN; RECURRENT VENOUS THROMBOEMBOLISM; FACTOR-V-LEIDEN; D-DIMER LEVELS; TISSUE-PLASMINOGEN ACTIVATOR; SIMPLE CLINICAL-MODEL; VENA-CAVA FILTERS; UNFRACTIONATED HEPARIN; RISK-FACTORS; COMPUTED-TOMOGRAPHY;
D O I
10.1016/S0140-6736(09)60996-X
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Pulmonary embolism (PE) is the leading cause of maternal mortality in the developed world. Mortality from PE in pregnancy might be related to challenges in targeting the right population for prevention, ensuring that diagnosis is suspected and adequately investigated, and initiating timely and best possible treatment of this disease. Pregnancy is an example of Virchow's triad: hypercoagulability, venous stasis, and vascular damage; together these factors lead to an increased incidence of venous thromboembolism. This disorder is often suspected in pregnant women because some of the physiological changes of pregnancy mimic its signs and symptoms. Despite concerns for fetal teratogenicity and oncogenicity associated with diagnostic testing, and potential adverse effects of pharmacological treatment, an accurate diagnosis of PE and a timely therapeutic intervention are crucial. Appropriate prophylaxis should be weighed against the risk of complications and offered according to risk stratification.
引用
收藏
页码:500 / 512
页数:13
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