[Treatment to pregnant women with deep venous thrombosis experience at Instituto Nacional de Perinatología].

BACKGROUND

Pregnant patients have five-fold venous thrombosis than no pregnant, and its therapy is mainly with non-fractioned and low molecular weight heparin.

OBJECTIVE

To know clinical characteristics, treatment and perinatal results of deep venous thrombosis associated to pregnancy at Instituto Nacional de Perinatologia.

MATERIAL AND

METHODS

Review of the files of patients with diagnosis, prenatal control, and resolution of deep venous thrombosis at Instituto Nacional de Perinatologia.

RESULTS

A total of 45 cases with deep venous thrombosis and pregnancy are described, with: age 29.3 +/- 6 years; gestations, 2.3 +/- 1.2; body mass index, 27.3 +/- 3.5.

RISK FACTORS: peripheral venous insufficiency, 17 (37.8%); obesity, 11 (24.4%); previous deep venous thrombosis, 10 (22.2%); antiphospholipid syndrome, 2 (4.4%); and protein S deficiency, 1 (2.2%). Diagnosis by gestational age: first trimester 10 (22%), second trimester 18 (40%), third trimester 15 (34%), and puerperium 2 (4%). Affected pelvic member: left, 32 (71%); right, 12 (27%); bilateral, 1 (2%). Initial treatment was always with non-fractionated heparin, and prevention of recurrence was made with acenocumarin in 41 cases (93%), and with non-fractionated heparin in 4 (7%). Resolution of pregnancy was 38.1 +/- 2 weeks of gestation: vaginal delivery, 18 cases (40%); cesarean, 27 (60%). Weight at birth was 3,026 +/- 464 g, with Apgar score < 6 in one case. In four cases there were four therapy-derived complications (3 with echymosis and epistaxis and 1 with macroscopic hematuria).

CONCLUSIONS

Timely and appropriate therapy of deep venous thrombosis during pregnancy prevents thromboembolic complications, and generally is associated to satisfactory maternal and fetal results.