The Risk of Thrombosis Around Pregnancy: Where Do We Stand?
Pregnancy and puerperium increase the relative risk of venous thromboembolism (VTE) and the absolute risk remains low, around 1 per 1,000, with induced mortality of around 1 per 100,000. Analysis of large databases has helped specify the modes of presentation and risk factors (RF) whose impact is gr...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.901869/full |
| _version_ | 1818253978841907200 |
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| author | Jean-Christophe Gris Jean-Christophe Gris Jean-Christophe Gris Jean-Christophe Gris Florence Guillotin Mathias Chéa Chloé Bourguignon Chloé Bourguignon Sylvie Bouvier Sylvie Bouvier Sylvie Bouvier |
| author_facet | Jean-Christophe Gris Jean-Christophe Gris Jean-Christophe Gris Jean-Christophe Gris Florence Guillotin Mathias Chéa Chloé Bourguignon Chloé Bourguignon Sylvie Bouvier Sylvie Bouvier Sylvie Bouvier |
| author_sort | Jean-Christophe Gris |
| collection | DOAJ |
| description | Pregnancy and puerperium increase the relative risk of venous thromboembolism (VTE) and the absolute risk remains low, around 1 per 1,000, with induced mortality of around 1 per 100,000. Analysis of large databases has helped specify the modes of presentation and risk factors (RF) whose impact is greater after than before childbirth, since VTE during pregnancy and post-partum obey different RFs. The evolution of the population concerned (mostly women over 35, obese, of multi-ethnicity undergoing medically assisted reproduction) affects the frequency of these RFs. Pulmonary embolism (PE) is over-represented after childbirth, but 30% of PE in pregnancy occurs without any RFs. Recommendations for prevention, mainly from expert groups, are heterogeneous and often discordant. Low molecular weight heparins (LMWH) are the mainstay of pharmacological thromboprophylaxis, in a field where randomized controlled studies are definitely lacking. VTE risk assessment in pregnancy must be systematic and repetitive. Risk assessment methods and scores are beginning to emerge to guide thromboprophylaxis and should be used more systematically. In the future, analyzing observational data from huge, nationwide registries and prospective cluster clinical trials may bring to light clinically relevant outcomes likely to feed comprehensive guidelines. |
| first_indexed | 2024-12-12T16:48:40Z |
| format | Article |
| id | doaj.art-2b43ca6cd67c48d18a6e51dddf256713 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-12T16:48:40Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-2b43ca6cd67c48d18a6e51dddf2567132022-12-22T00:18:24ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-05-01910.3389/fcvm.2022.901869901869The Risk of Thrombosis Around Pregnancy: Where Do We Stand?Jean-Christophe Gris0Jean-Christophe Gris1Jean-Christophe Gris2Jean-Christophe Gris3Florence Guillotin4Mathias Chéa5Chloé Bourguignon6Chloé Bourguignon7Sylvie Bouvier8Sylvie Bouvier9Sylvie Bouvier10Department of Hematology, Nîmes University Hospital, Nîmes, FranceDepartment of Hematology, Faculty of Pharmaceutical and Biological Sciences, Montpellier University, Montpellier, FranceUMR UA11 INSERM-Montpellier University IDESP, Montpellier, FranceDepartment of Obstetrics and Gynecology, First Ivan Setchenov Medical University, Moscow, RussiaDepartment of Hematology, Nîmes University Hospital, Nîmes, FranceDepartment of Hematology, Nîmes University Hospital, Nîmes, FranceDepartment of Hematology, Nîmes University Hospital, Nîmes, FranceUMR UA11 INSERM-Montpellier University IDESP, Montpellier, FranceDepartment of Hematology, Nîmes University Hospital, Nîmes, FranceDepartment of Hematology, Faculty of Pharmaceutical and Biological Sciences, Montpellier University, Montpellier, FranceUMR UA11 INSERM-Montpellier University IDESP, Montpellier, FrancePregnancy and puerperium increase the relative risk of venous thromboembolism (VTE) and the absolute risk remains low, around 1 per 1,000, with induced mortality of around 1 per 100,000. Analysis of large databases has helped specify the modes of presentation and risk factors (RF) whose impact is greater after than before childbirth, since VTE during pregnancy and post-partum obey different RFs. The evolution of the population concerned (mostly women over 35, obese, of multi-ethnicity undergoing medically assisted reproduction) affects the frequency of these RFs. Pulmonary embolism (PE) is over-represented after childbirth, but 30% of PE in pregnancy occurs without any RFs. Recommendations for prevention, mainly from expert groups, are heterogeneous and often discordant. Low molecular weight heparins (LMWH) are the mainstay of pharmacological thromboprophylaxis, in a field where randomized controlled studies are definitely lacking. VTE risk assessment in pregnancy must be systematic and repetitive. Risk assessment methods and scores are beginning to emerge to guide thromboprophylaxis and should be used more systematically. In the future, analyzing observational data from huge, nationwide registries and prospective cluster clinical trials may bring to light clinically relevant outcomes likely to feed comprehensive guidelines.https://www.frontiersin.org/articles/10.3389/fcvm.2022.901869/fullpregnancypuerperiumthrombosisrisk factorprophylaxis |
| spellingShingle | Jean-Christophe Gris Jean-Christophe Gris Jean-Christophe Gris Jean-Christophe Gris Florence Guillotin Mathias Chéa Chloé Bourguignon Chloé Bourguignon Sylvie Bouvier Sylvie Bouvier Sylvie Bouvier The Risk of Thrombosis Around Pregnancy: Where Do We Stand? Frontiers in Cardiovascular Medicine pregnancy puerperium thrombosis risk factor prophylaxis |
| title | The Risk of Thrombosis Around Pregnancy: Where Do We Stand? |
| title_full | The Risk of Thrombosis Around Pregnancy: Where Do We Stand? |
| title_fullStr | The Risk of Thrombosis Around Pregnancy: Where Do We Stand? |
| title_full_unstemmed | The Risk of Thrombosis Around Pregnancy: Where Do We Stand? |
| title_short | The Risk of Thrombosis Around Pregnancy: Where Do We Stand? |
| title_sort | risk of thrombosis around pregnancy where do we stand |
| topic | pregnancy puerperium thrombosis risk factor prophylaxis |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.901869/full |
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