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中华妇幼临床医学杂志(电子版) ›› 2024, Vol. 20 ›› Issue (04) : 367 -373. doi: 10.3877/cma.j.issn.1673-5250.2024.04.002

围产医学专辑

妊娠相关深静脉血栓形成患者的预后研究现状
姚金含1,2, 王伟娜1,2, 张玉泉2,()   
  1. 1.南通大学医学院,南通 226001
    2.南通大学附属医院妇产科,南通 226001
  • 收稿日期:2024-02-19 修回日期:2024-07-11 出版日期:2024-08-01
  • 通信作者: 张玉泉
  • 基金资助:
    江苏省医学创新团队基金项目(苏卫科教〔2017〕1号)

Current research status on prognosis of patients with pregnancy-related deep vein thrombosis

Jinhan Yao1,2, Weina Wang1,2, Yuquan Zhang1,()   

  1. 1.Department of Obstetrics and Gynecology,Affiliated Hospital of Nantong University,Nantong 226001,Jiangsu Province,China
    2.Medical School of Nantong University,Nantong 226001,Jiangsu Province,China
  • Received:2024-02-19 Revised:2024-07-11 Published:2024-08-01
  • Corresponding author: Yuquan Zhang
引用本文:

姚金含, 王伟娜, 张玉泉. 妊娠相关深静脉血栓形成患者的预后研究现状[J]. 中华妇幼临床医学杂志(电子版), 2024, 20(04): 367-373.

Jinhan Yao, Weina Wang, Yuquan Zhang. Current research status on prognosis of patients with pregnancy-related deep vein thrombosis[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2024, 20(04): 367-373.

静脉血栓栓塞症(VTE)在孕期和产褥期女性的发生风险远高于非孕期女性。尽管严格防治,目前VTE仍然是导致孕产妇死亡的主要原因之一。迄今国内关于妊娠相关深静脉血栓形成(DVT)患者预后,特别是母儿妊娠结局的研究均尚较少。笔者拟就妊娠相关DVT 的发病率及其发病机制,以及妊娠相关DVT 孕产妇治疗与预后、长期生活质量,死亡、复发情况与预后研究存在问题的最新研究进展及现状进行阐述,旨在引起产科临床对妊娠相关DVT 患者不良预后的重视,为妊娠相关DVT 相关研究及临床规范诊疗提供参考。

Venous thromboembolism(VTE)is at much higher risk in pregnant and puerperal women than in non-pregnant women and remains one of the leading causes of maternal death despite intensive prevention and control.However,up to now there have been relatively few studies in China on the long-term prognosis of patients with pregnancy-related deep vein thrombosis (DVT),especially on pregnancy outcomes of maternal and infant.This review intends to summarize the latest research progress and current situation among the incidence and pathogenesis of pregnancy-related DVT,and treatment and prognosis,long-term quality of life,death,recurrence of pregnancy-related DVT,and problems in prognosis of pregnancy-related DVT,in order to improve obstetrical department's attention to poor prognosis of pregnancy-related DVT,and provide reference for future related research and clinical norms of pregnancy-related DVT.

[1]
Petersen EE,Davis NL,Goodman D,et al.Racial/ethnic disparities in pregnancy-related deaths-United States,2007-2016[J].MMWR Morb Mortal Wkly Rep,2019,68(35):762-765.DOI:10.1*-9+5585/mmwr.mm6835a3.
[2]
Abe K,Kuklina EV,Hooper WC,et al.Venous thromboembolism as a cause of severe maternal morbidity and mortality in the United States[J].Semin Perinatol,2019,43(4):200-204.DOI:10.1053/j.semperi.2019.03.004.
[3]
曹明欣,张俊隆,丘少鹏,等.嗜酸性膀胱炎合并髂静脉血栓一例报告并文献复习[J/OL].中华腔镜泌尿外科杂志(电子版),2022,16(4):367-371.DOI:10.3877/cma.j.issn.1674-3253.2022.04.019.Cao MX,Zhang JL,Qiu SP,et al.Eosinophilic cystitis complicated with iliac vein thrombosis:a case report and literatures review [J/OL].Chin J Endourol(Electronic Edition),2022,16(4):367-371.DOI:10.3877/cma.j.issn.1674-3253.2022.04.019.
[4]
车焱.我国妇产科静脉血栓栓塞症发生率研究现状[J].中国实用妇科与产科杂志,2018,34(7):709-713.DOI:10.19538/j.fk2018070102.Che Y.A review of the incidence of venous thromboembolism among gynecological and obstetrical patients in China[J].Chin J Pract Gynecol Obstet,2018,34(7):709-713.DOI:10.19538/j.fk2018070102.
[5]
Bukhari S,Fatima S,Barakat AF,et al.Venous thromboembolism during pregnancy and postpartum period[J].Eur J Intern Med,2022,97:8-17.DOI:10.1016/j.ejim.2021.12.013.
[6]
Pastori D,Cormaci VM,Marucci S,et al.A comprehensive review of risk factors for venous thromboembolism:from epidemiology to pathophysiology[J].Int J Mol Sci,2023,24(4):3169.DOI:10.3390/ijms24043169.
[7]
Lao TT.Pulmonary embolism in pregnancy and the puerperium[J].Best Pract Res Clin Obstet Gynaecol,2022,85(Pt A):96-106.DOI:10.1016/j.bpobgyn.2022.06.003.
[8]
Elgendy IY,Fogerty A,Blanco-MolinaÁ,et al.Clinical characteristics and outcomes of women presenting with venous thromboembolism during pregnancy and postpartum period:findings from the RIETE registry[J].Thromb Haemost,2020,120(10):1454-1462.DOI:10.1055/s-0040-1714211.
[9]
Parks AL,Fazili M,Aston V,et al.Excluding pregnancyassociated deep vein thrombosis with whole-leg ultrasound[J].Res Pract Thromb Haemost,2023,7(7):102202.DOI:10.1016/j.rpth.2023.102202.
[10]
Wang L,Zhang C,Mu S,et al.Safety of catheter-directed thrombolysis for the treatment of acute lower extremity deep vein thrombosis:a systematic review and Meta-analysis[J].Medicine (Baltimore),2017,96(35):e7922.DOI:10.1097/md.0000000000007922.
[11]
上海市母婴安全专家委员会, 上海市医学会围产医学专科分会, 上海市医学会妇产科专科分会产科学组, 等.上海市产科静脉血栓栓塞症防治的专家共识 [J].上海医学,2020,43(11):645-650.DOI:10.19842/j.cnki.issn.0253-9934.2020.11.001.Shanghai Maternal and Child Safety Expert Committee,Shanghai Medical Association Perinatal Medicine Specialty Committee,Obstetrics Group of the Shanghai Medical Association Obstetrics and Gynecology Specialty C ommittee,et al.Expert consensus on prevention and treatment of obstetric venous thromboembolism in Shanghai[J].Shanghai Med J,2020,43(11):645-650.DOI:10.19842/j.cnki.issn.0253-9934.2020.11.001.
[12]
Ortel TL,Neumann I,Ageno W,et al.American society of hematology 2020 guidelines for management of venous thromboembolism:treatment of deep vein thrombosis and pulmonary embolism[J].Blood Adv,2020,4(19):4693-4738.DOI:10.1182/bloodadvances.2020001830.
[13]
徐琴, 周容.妊娠期及产褥期静脉血栓栓塞症的流行病学特征及发生机制 [J].实用妇产科杂志,2022,38(5):321-324.Xu Q,Zhou R.Epidemiological characteristics and pathogenesis of venous thromboembolism during pregnancy and puerperal period[J].J Pract Obstet Gynecol,2022,38(5):321-324.
[14]
Regitz-Zagrosek V,Roos-Hesselink JW,Bauersachs J,et al.2018 ESC guidelines for the management of cardiovascular diseases during pregnancy[J].Kardiol Pol,2019,77(3):245-326.DOI:10.5603/kp.2019.0049.
[15]
张川, 张力, 李泳琴, 等.低分子肝素用于妊娠期安全性的系统评价 [J].中国循证医学杂志,2021,21(11):1259-1268.DOI:10.7507/1672-2531.202107078.Zhang C,Zhang L,Li YQ,et al.Safety of low-molecularweight heparin in pregnancy:a systematic review[J].Chin J Evid Base Med,2021,21(11):1259-1268.DOI:10.7507/1672-2531.202107078.
[16]
陈丽宇, 肖娟, 吕仙忠, 等.影响孕产妇下肢深静脉血栓预后的危险因素分析 [J].山东大学学报(医学版),2021,59(7):38-42.DOI:10.6040/j.issn.1671-7554.0.2021.0482.Chen LY,Xiao J,Lyu XZ,et al.Risk factors influencing prognosis of lower extremity deep vein thrombosis in pregnant and parturient women[J].J Shandong Univ(Health Sci),2021,59(7):38-42.DOI:10.6040/j.issn.1671-7554.0.2021.0482.
[17]
Elmofty DH,Tucker A,Wuenstel AM,et al.Varying dosages of subcutaneous unfractionated heparin and activated partial thromboplastin time in hospitalized antepartum patients:a retrospective cohort analysis[J].Anesth Analg,2022,134(5):1028-1034.DOI:10.1213/ane.0000000000 005866.
[18]
Chopard R,Albertsen IE,Piazza G.Diagnosis and treatment of lower extremity venous thromboembolism:a review[J].JAMA,2020,324(17):1765-1776.DOI:10.1001/jama.2020.17272.
[19]
Sessa M,Mascolo A,Callréus T,et al.Direct-acting oral anticoagulants (DOACs)in pregnancy:new insight from VigiBase®[J].Sci Rep,2019,9(1):7236.DOI:10.1038/s41598-019-43715-4.
[20]
Beyer-Westendorf J,Marten S.Reproductive issues in women on direct oral anticoagulants[J].Res Pract Thromb Haemost,2021,5(4):e12512.DOI:10.1002/rth2.12512.
[21]
Roberti R,Iannone LF,Palleria C,et al.Direct oral anticoagulants:from randomized clinical trials to real-world clinical practice[J].Front Pharmacol,2021,12:684638.DOI:10.3389/fphar.2021.684638.
[22]
Kahn SR,Julian JA,Kearon C,et al.Quality of life after pharmacomechanical catheter-directed thrombolysis for proximal deep venous thrombosis[J].J Vasc Surg Venous Lymphat Disord,2020,8(1):8-23.e18.DOI:10.1016/j.jvsv.2019.03.023.
[23]
Du X,Zhuang H,Hong L,et al.Long-term outcome of catheter-directed thrombolysis in pregnancy-related venous thrombosis[J].Med Sci Monit,2019,25:3771-3777.DOI:10.12659/msm.914592.
[24]
Paz T,Bloom A,Roth B,et al.Pharmacomechanical catheter thrombolysis for pregnancy-related proximal deep venous thrombosis:prevention of post-thrombotic syndrome[J].J Matern Fetal Neonatal Med,2021,34(9):1441-1447.DOI:10.1080/14767058.2019.1638900.
[25]
Bates SM,Rajasekhar A,Middeldorp S,et al.American Society of Hematology 2018 guidelines for management of venous thromboembolism:venous thromboembolism in the context of pregnancy[J].Blood Adv,2018,2(22):3317-3359.DOI:10.1182/bloodadvances.2018024802.
[26]
Kalaitzopoulos DR,Panagopoulos A,Samant S,et al.Management of venous thromboembolism in pregnancy[J].Thromb Res,2022,211:106-113.DOI:10.1016/j.thromres.2022.02.002.
[27]
Bourgioti C,Konidari M,Gourtsoyianni S,et al.Imaging during pregnancy:what the radiologist needs to know[J].Diagn Interv Imaging,2021,102(10):593-603.DOI:10.1016/j.diii.2021.05.003.
[28]
Wik HS,Enden TR,Jacobsen AF,et al.Long-term quality of life after pregnancy-related deep vein thrombosis and the influence of socioeconomic factors and comorbidity[J].J Thromb Haemost,2011,9(10):1931-1936.DOI:10.1111/j.1538-7836.2011.04468.x.
[29]
O'Shaugnessy F,Govindappagari S,Huang Y,et al.Postthrombotic syndrome and chronic pulmonary embolism after obstetric venous thromboembolism [J].Am J Perinatol,2023,40(1):22-24.DOI:10.1055/s-0041-1739471.
[30]
Al-Husban N,Alnsour LN,El-Adwan Z,et al.Impact of pregnancy-related venous thromboembolism on quality of patients'lives[J].Clin Appl Thromb Hemost,2021,27:10760296211040873.DOI:10.1177/10760296211040873.
[31]
Shirazi M,Sahebdel B,Torkzaban M,et al.Maternal mortality following thromboembolism;incidences and prophylaxis strategies[J].Thromb J,2020,18(1):36.DOI:10.1186/s12959-020-00251-w.
[32]
Lawrence ER,Klein TJ,Beyuo TK.Maternal mortality in low and middle-income countries[J].Obstet Gynecol Clin North Am,2022,49(4):713-733.DOI:10.1016/j.ogc.2022.07.001.
[33]
Wang S,Rexrode KM,Florio AA,et al.Maternal mortality in the United States:trends and opportunities for prevention[J].Annu Rev Med,2023,74:199-216.DOI:10.1146/annurev-med-042921-123851.
[34]
Lucas DN,Bamber JH.UK confidential enquiry into maternal deaths-still learning to save mothers'lives[J].Anaesthesia,2018,73(4):416-420.DOI:10.1111/anae.14246.
[35]
Morikawa M,Adachi T,Itakura A,et al.A retrospective cohort study using a national surveillance questionnaire to investigate the characteristics of maternal venous thromboembolism in Japan in 2018[J].BMC Pregnancy Childbirth,2021,21(1):514.DOI:10.1186/s12884-021-03993-1.
[36]
Kourlaba G,Relakis J,Kontodimas S,et al.A systematic review and Meta-analysis of the epidemiology and burden of venous thromboembolism among pregnant women[J].Int J Gynaecol Obstet,2016,132(1):4-10.DOI:10.1016/j.ijgo.2015.06.054.
[37]
Barillari G,Londero AP,Brenner B,et al.Recurrence of venous thromboembolism in patients with recent gestational deep vein thrombosis or pulmonary embolism:findings from the RIETE Registry[J].Eur J Intern Med,2016,32:53-59.DOI:10.1016/j.ejim.2016.02.013.
[38]
张家怡, 张玉泉.妇产科患者静脉血栓栓塞症风险评估模型的研究现状 [J/OL].中华妇幼临床医学杂志(电子版),2021,17(1):15-22.DOI:10.3877/cma.j.issn.1673-5250.2021.01.003.Zhang JY,Zhang YQ.Current research status of venous thromboembolism risk assessment models among obstetrics and gynecology patients[J/OL].Chin J Obstet Gynecol Pediatr (Electron Ed),2021,17(1):15-22.DOI:10.3877/cma.j.issn.1673-5250.2021.01.003.
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