PMID- 12393666
OWN - NLM
STAT- MEDLINE
DCOM- 20030310
LR  - 20210206
IS  - 0006-4971 (Print)
IS  - 0006-4971 (Linking)
VI  - 100
IP  - 10
DP  - 2002 Nov 15
TI  - How we manage venous thromboembolism during pregnancy.
PG  - 3470-8
AB  - During pregnancy, physiologic and anatomic changes can complicate the diagnosis 
      of venous thromboembolism (VTE) as well as the management of patients with a high 
      risk of or established VTE. As in nonpregnant subjects, clinical diagnosis of VTE 
      by itself is unreliable and accurate objective testing is essential. Few 
      diagnostic studies of VTE have been performed in pregnant women and, therefore, 
      approaches are largely extrapolated from those used in nonpregnant subjects with 
      modifications to limit the radiation exposure and overcome the limitations of 
      diagnostic testing in pregnancy. Therapy of established VTE during pregnancy 
      consists of therapeutic doses of unfractionated heparin (UFH) or 
      low-molecular-weight heparin (LMWH), generally given throughout pregnancy 
      subcutaneously and for 4 to 6 weeks after childbirth. A key unresolved issue 
      includes the optimum dosing of LMWH therapy. Maternal warfarin can be safely used 
      after childbirth because it is safe to use in the breast-fed infant of a mother 
      receiving warfarin. Finally, pregnant women with prior VTE (with or without a 
      hypercoagulable state) have an increased risk of recurrent venous thrombosis. A 
      recent study has demonstrated that for women with a single episode of prior VTE, 
      many can be managed without anticoagulants. However, for many, anticoagulant 
      therapy with prophylactic UFH or LMWH is a reasonable option.
FAU - Bates, Shannon M
AU  - Bates SM
AD  - Department of Medicine, McMaster University, Hamilton, ON, Canada.
FAU - Ginsberg, Jeffrey S
AU  - Ginsberg JS
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20020712
PL  - United States
TA  - Blood
JT  - Blood
JID - 7603509
RN  - 0 (Anticoagulants)
SB  - IM
MH  - Anticoagulants/administration & dosage/adverse effects
MH  - Diagnostic Imaging/adverse effects/methods
MH  - Female
MH  - Humans
MH  - Practice Guidelines as Topic
MH  - Pregnancy
MH  - Pregnancy Complications, Hematologic/diagnosis/*drug therapy
MH  - Risk Assessment
MH  - Thromboembolism/diagnosis/drug therapy
MH  - Venous Thrombosis/diagnosis/*drug therapy
RF  - 85
EDAT- 2002/10/24 04:00
MHDA- 2003/03/11 04:00
CRDT- 2002/10/24 04:00
PHST- 2002/10/24 04:00 [pubmed]
PHST- 2003/03/11 04:00 [medline]
PHST- 2002/10/24 04:00 [entrez]
AID - S0006-4971(20)54103-7 [pii]
AID - 10.1182/blood-2002-03-0965 [doi]
PST - ppublish
SO  - Blood. 2002 Nov 15;100(10):3470-8. doi: 10.1182/blood-2002-03-0965. Epub 2002 Jul 
      12.