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Thrombose und Lungenembolie in der Schwangerschaft

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Kardiovaskuläre Notfälle bei Frauen

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Zusammenfassung

Eine physio logische, über die Gravidität zunehmende Hyperkoagulabilität er höht das Risiko, während oder nach der Schwangerschaft eine venöse Thromboembolie zu erleiden um den Faktor 5, insbesondere wenn zusätzlich eine Throm bophilie vorliegt. Trotzdem Lungenembolien in der Gravidität selten auftreten sind sie doch die Hauptursache für maternale Mortalität. Klinische Zeichen sind oft mals unspezifisch, daher muss de Verdacht mit apparativen Untersuchungen validiert werden. Ultraschallverfahren werden bevorzugt. Bei unauffälligem Befund und hohem klinischen Verdacht sollte auf radiologische Bildgebung wegen der nur geringen Strahlenbelastung nicht verzichtei werden; dies gilt insbesondere für die Lungenembolie. Zur medikamentösen Prophylaxe und Therapie sollte niedermolekulares dem unfraktionierten Heparin wegen des günstigeren Nebenwirkungsprofils vorzogen werden. Kumarine sollten wegen ihrer teratogenen Wirkung bis auf Ausnahmesi tuationen während der Schwangerschaft nicht gegeben werden, sind aber postpartal anwendbar.

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Literatur

  1. Guidelines on diagnosis and management of acute pulmonary embolism (2000) Task force on pulmonary embolism. European society of cardiology. Eur Heart J 21(16):1301–1336

    Article  Google Scholar 

  2. Bates SM, Ginsberg JS (2002) How we manage venous thromboembolism during pregnancy. Blood [epub ahead of print]

    Google Scholar 

  3. Brill-Edwards P, Ginsberg JS, Gent M, Hirsh J, Burrows R, Kearon C, Geerts W, Kovacs M, Weitz JI, Robinson KS, Whittom R, Couture G (2000) Safety of withholding heparin in pregnant women with a history of venous thromboembolism. Recurrence of clot in this pregnancy study group. N Engl J Med 343(20):1439–1444

    Article  PubMed  CAS  Google Scholar 

  4. Clark P, Twaddle S, Walker ID, Scott L, Greer IA (2002) Cost-effectiveness of screening for the factor V Leiden mutation in pregnant women. Lancet 359(9321):1919–1920

    Article  PubMed  Google Scholar 

  5. Dizon-Townson D (2002) Pregnancy-related venous thromboembolism. Clin Obstet Gynecol 45(2):363–368

    Article  PubMed  Google Scholar 

  6. Eldor A (2002) The use of low-molecular-weight heparin for the management of venous thromboembolism in pregnancy. Eur J Obstet Gynecol Reprod Biol 104(1):3–13

    Article  PubMed  CAS  Google Scholar 

  7. Eldor A (2001) Thrombophilia and its treatment in pregnancy. J Thromb Thrombolysis 12(l):23–30

    Article  PubMed  CAS  Google Scholar 

  8. Eldor A (2001) Thrombophilia, thrombosis and pregnancy. Thromb Haemost 86(l):104–111

    PubMed  CAS  Google Scholar 

  9. Gerhardt A, Scharf RE, Beckmann MW, Struve S, Bender HG, Pillny M, Sandmann W, Zotz RB (2000) Prothrombin and factor V mutations in women with a history of thrombosis during pregnancy and the Puerperium. N Engl J Med 342(6):374–380

    Article  PubMed  CAS  Google Scholar 

  10. Ginsberg JS, Greer I, Hirsh J (2001) Use of antithrombotic agents during pregnancy. Chest 119(Suppl 1):122S–131S

    Article  PubMed  CAS  Google Scholar 

  11. Goldhaber SZ (2001) Thrombolysis in pulmonary embolism: a debatable indication. Thromb Haemost 86(1):444–451

    PubMed  CAS  Google Scholar 

  12. Greer IA (2002) Exploring the role of low-molecular-weight heparins in pregnancy. Semin Thromb Hemost 28(Suppl 3):25–32

    Article  PubMed  CAS  Google Scholar 

  13. Greer IA (2001) Management of venous thromboembolism in pregnancy. Best Pract Res Clin Obstet Gynaecol 15(4):583–603

    Article  PubMed  CAS  Google Scholar 

  14. Greer IA (2001) The acute management of venous thromboembolism in pregnancy. Curr Opin Obstet Gynecol 13(6):569–575

    Article  PubMed  CAS  Google Scholar 

  15. Greer IA (2000) The challenge of thrombophilia in maternal-fetal medicine. N Engl J Med 342(6):424–425

    Article  PubMed  CAS  Google Scholar 

  16. Konstantinides S, Geibel A, Heusel G, Heinrich F, Kasper W (2002) Heparin plus alteplase compared with heparin alone in patients with submassive pulmonary embolism. N Engl J Med 347(15):1143–1150

    Article  PubMed  CAS  Google Scholar 

  17. Lagrange F, Vergnes C, Brun JL, Paolucci F, Nadal T, Leng JJ, Saux MC, Banwarth B (2002) Absence of placental transfer of pentasaccharide (Fondaparinux, Arixtra) in the dually perfused human cotyledon in vitro. Thromb Haemost 87(5):831–835

    PubMed  CAS  Google Scholar 

  18. Lepercq J, Conard J, Borel-Derlon A, Darmon JY, Boudignat O, Francoual C, Priollet P, Cohen C, Yvelin N, Schved JF, Tournaire M, Borg JY (2001) Venous thromboembolism during pregnancy: a retrospective study of enoxaparin safety in 624 pregnancies. BJOG 108(11):1134–1140

    PubMed  CAS  Google Scholar 

  19. Martinelli I, De Stefano V, Taioli E, Paciaroni K, Rossi E, Mannucci PM (2002) Inherited thrombophilia and first venous thromboembolism during pregnancy and puerperium. Thromb Haemost 87(5):791–795

    PubMed  CAS  Google Scholar 

  20. Meinardi JR, Middeldorp S, de Kam PJ, Koopman MM, van Pampus EC, Hamulyak K, Prins MH, Buller HR, van der Meer J (2002) The incidence of recurrent venous thromboembolism in carriers of factor V Leiden is related to concomitant thrombophilic disorders. Br J Haematol 116(3):625–631

    Article  PubMed  Google Scholar 

  21. Middeldorp S, Libourel EJ, Hamulyak K, Van der Meer J, Buller HR (2001) The risk of pregnancy-related venous thromboembolism in women who are homozygous for factor V Leiden. Br J Haematol 113(2):553–555

    Article  PubMed  CAS  Google Scholar 

  22. Middeldorp S, Meinardi JR, Koopman MM, van Pampus EC, Hamulyak K, van Der Meer J, Prins MH, Buller HR (2001) A prospective study of asymptomatic carriers of the factor V Leiden mutation to determine the incidence of venous thromboembolism. Ann Intern Med 135(5):322–327

    PubMed  CAS  Google Scholar 

  23. Pabinger I, Grafenhofer H, Kyrle PA, Quehenberger P, Mannhalter C, Lechner K, Kaider A (2002) Temporary increase in the risk for recurrence during pregnancy in women with a history of venous thromboembolism. Blood 100(3):1060–1062

    Article  PubMed  CAS  Google Scholar 

  24. Rodie VA, Thomson AJ, Stewart FM, Quinn AJ, Walker ID, Greer IA (2002) Low molecular weight heparin for the treatment of venous thromboembolism in pregnancy: a case series. BJOG 109(9):1020–1024

    Article  PubMed  CAS  Google Scholar 

  25. Rudofsky G, Michler E (2002) Diagnostic imaging of deep leg and pelvic vein thromboses. Internist (Berl) 43(l):27–28, 31–35

    Article  CAS  Google Scholar 

  26. Schellong SM, Schwarz T (2002) Differential therapy of deep venous thrombosis of the leg veins. Internist (Berl) 43(1):36, 39–46

    Article  CAS  Google Scholar 

  27. Vieillard-Baron A, Page B, Augarde R, Prin S, Qanadli S, Beauchet A, Du-bourg O, Jardin F (2001) Acute cor pulmonale in massive pulmonary embolism: incidence, echocardiographic pattern, clinical implications and recovery rate. Intensive Care Med 27(9):1481–1486

    Article  PubMed  CAS  Google Scholar 

  28. Winer-Muram HT, Boone JM, Brown HL, Jennings SG, Mabie WC, Lombardo GT (2002) Pulmonary embolism in pregnant patients: fetal radiation dose with helical CT. Radiology 224:487–492

    Article  PubMed  Google Scholar 

  29. Yap LB, Alp NJ, Forfar JC (2002) Thrombolysis for acute massive pulmonary embolism during pregnancy. Int J Cardiol 82(2):193–194

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Schwerpunkt Kardiologie, Angiologie, Pneumologie Universitätsklinikum Charité, Medizinische Klinik Campus Mitte, Schumannstr. 20-21, 101117, Berlin, Germany

    Dr. Michael Laule, Prof. Dr. Gert Baumann & Prof. Dr. Karl Stangl

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  1. Dr. Michael Laule
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  2. Prof. Dr. Gert Baumann
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  3. Prof. Dr. Karl Stangl
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Editors and Affiliations

  1. Medizinische Klinik, mit Schwerpunkt Kardiologie, Pneumologie, Angiologie, Universitätsmedizin Berlin, Schumannstr. 20/21, 10117, Berlin, Germany

    Verena Stangl  & Gert Baumann (Charité der Humboldt-Universität) &  (Charité der Humboldt-Universität)

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© 2004 Springer-Verlag Berlin Heidelberg

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Laule, M., Baumann, G., Stangl, K. (2004). Thrombose und Lungenembolie in der Schwangerschaft. In: Stangl, V., Baumann, G. (eds) Kardiovaskuläre Notfälle bei Frauen. Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-7985-1946-6_5

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  • DOI: https://doi.org/10.1007/978-3-7985-1946-6_5

  • Publisher Name: Steinkopff, Heidelberg

  • Print ISBN: 978-3-7985-1488-1

  • Online ISBN: 978-3-7985-1946-6

  • eBook Packages: Springer Book Archive

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