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Management of deep vein thrombosis and pulmonary embolism (venous thromboembolism) during pregnancy

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Abstract

Purpose

The risk of venous thromboembolism (VTE) is high during pregnancy. Although most patients with VTE are safely treated via medications, the optimal treatment for massive pulmonary embolism remains controversial. To evaluate the safety and efficacy of VTE management during pregnancy, we report our single center experience of treating VTE in pregnant women.

Methods

Case records were retrospectively reviewed from seven patients who underwent treatment for venous thromboembolism between 2002 and 2014.

Results

Mean gestational time was 28 ± 6.2 weeks. Four patients with deep vein thrombosis were treated medically, and they all had vaginal delivery at full term without hemorrhagic complication. Three patients with massive pulmonary embolism underwent surgical embolectomy. Two of these three patients underwent cesarean delivery at 28 and 29 weeks respectively. There was no maternal death, but one fetal death occurred during surgical embolectomy.

Conclusion

VTE during pregnant women is safely managed by anticoagulant therapy. Massive pulmonary embolism during pregnancy can be managed safely by surgical embolectomy using cardiopulmonary bypass, but the rate of fetal loss remains high.

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Acknowledgments

A part of this paper was read at the Joint Symposium in the 25th Annual Meeting of the Japan Society of Obstetrical, Gynecological and Neonatal Hematology (June 6, 2015, Tokyo) sponsored by Japanese Society for Cardiovascular Surgery.

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Authors and Affiliations

  1. Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan

    Wakako Fukuda, Mari Chiyoya, Satoshi Taniguchi, Kazuyuki Daitoku & Ikuo Fukuda

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  1. Wakako Fukuda
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  2. Mari Chiyoya
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  3. Satoshi Taniguchi
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  4. Kazuyuki Daitoku
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  5. Ikuo Fukuda
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Correspondence to Ikuo Fukuda.

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Fukuda, W., Chiyoya, M., Taniguchi, S. et al. Management of deep vein thrombosis and pulmonary embolism (venous thromboembolism) during pregnancy. Gen Thorac Cardiovasc Surg 64, 309–314 (2016). https://doi.org/10.1007/s11748-016-0635-2

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  • DOI: https://doi.org/10.1007/s11748-016-0635-2

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