Zusammenfassung
Venöse und arterielle Thrombosen sowie thromboembolische Komplikationen wie Lungenarterienembolien tragen weltweit maßgeblich zur Morbidität und Mortalität in der Schwangerschaft und Postpartalphase bei (Chang et al. 2003, Greer 2000, McColl et al. 2000a, Rosfors et al. 2001). Das Risiko venöser thromboembolischer Ereignisse ist bei gesunden Schwangeren im Vergleich zu nicht graviden Frauen gleichen Alters um etwa das 5-fache erhöht, das Risiko arterieller thromboembolischer Ereignisse (apoplektischer Insult, Myokardinfarkt) um das 3- bis 4-fache (James et al. 2005a, 2006a).
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Literatur
Andersen BS, Steffensen FH, Sorensen HT, Nielsen GL, Olsen J (1998) The cumulative incidence of venous thromboembolism during pregnancy and puerperium – an 11 year Danish population-based study of 63,300 pregnancies. Acta Obstetricia et Gynecologica Scandinavica 77: 170–173
Bates SA, Greer IA, Hirsh J, Ginsberg JS (2004) Use of antithrombotic agents during pregnancy. Chest 126: 627S–644S
Bates SM (2007) Management of pregnant women with thrombophilia or a history of venous thromboembolism. Hematology Am Soc Hematol Educ Program 2007: 143–150
Bates SM, Greer IA, Middeldorp S, Veenstra DL, Prabulos A-M, Vandvik PO (2012) VTE, thrombophilia and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practic guidelines. Chest 141: e691S–e736S
Bates SM, Greer IA, Pabinger I, Sofaer S, Hirsh J (2008) Venous thromboembolism, thrombophilia, antithrombotic therapy, and pregnancy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 133: 844S–886S
Bauersachs RM, Dudenhausen J, Faridi A et al. (2007) Risk stratification and heparin prophylaxis to prevent venous thromboembolism in pregnant women. Thromb Haemost 98: 1237–1245
Bertina RM, Koeleman BPC, Koster T, Rosendaal FR, Dirven RJ, deRonde H, Vandervelden PA, Reitsma PH (1994) Mutation in Blood-Coagulation Factor-V Associated with Resistance to Activated Protein-C. Nature 369: 64–67
Bremme KA (2003) Haemostatic changes in pregnancy. Best Practice & Research: Clinical Haematology 16: 153–168
Brenner B, Blumenfeld Z (1997) Thrombophilia and fetal loss. Blood Rev 11: 72–79
Brill-Edwards P, Ginsberg JS, Gent M et al. (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: 1439–1444
Chan WS (2009) The ’ART’ of thrombosis: a review of arterial and venous thrombosis in assisted reproductive technology. Curr Opin Obstet Gynecol 21: 207–218
Chan WS, Spencer FA, Ginsberg JS (2010) Anatomic distribution of deep vein thrombosis in pregnancy. Canadian Medical Association Journal 182: 657–660
Chang J, Elam-Evans LD, Berg CJ, Hemdon J, Flowers L, Seed KA, Syverson CJ (2003) Pregnancy-related mortality surveillance-United States, 1991-1999. MMWR Surveill Summ 52: 1–8
Conard J, Horellou MH, Vandreden P, Lecompte T, Samama M (1990) Thrombosis and Pregnancy in Congenital Deficiencies in At-Iii, Protein-C Or Protein-S - Study of 78 Women. Thromb Haemost 63: 319–320
Danilenko-Dixon DR, Heit JA, Silverstein MD, Yawn BP, Petterson TM, Lohse CM, Melton LJI (2001) Risk factors for deep vein thrombosis and pulmonary embolism during pregnancy or post partum: a population-based, case-control study. Am J Obstet Gynecol 184: 104–110
De Stefano V, Martinelli I, Rossi E, Battaglioli T, Za T, Mannucci PM, Leone G (2006) The risk of recurrent venous thromboembolism in pregnancy and puerperium without antithrombotic prophylaxis. Br J Haematol 135: 386–391
Delvigne A, Demoulin A, Smitz J, Donnez J, Koninckx P, Dhont M, Englert Y, Delbeke L, Darcis L, Gordts S (1993) The ovarian hyperstimulation syndrome in in-vitro fertilization: a Belgian multicentric study. I. Clinical and biological features. Hum Reprod 8: 1353–1360
DeStefano V, Leone G, Mastrangelo S et al. (1994) Thrombosis During Pregnancy and Surgery in Patients with Congenital Deficiency of Antithrombin-Iii, Protein-C, Protein-S. Thromb Haemost 71: 799–800
Dilley A, Austin H, El-Jamil M et al. (2000) Genetic factors associated with thrombosis in pregnancy in a United States population. Am J Obstet Gynecol 183: 1271–1277
Friederich PW, Sanson BJ, Simioni P et al. (1996) Frequency of pregnancy-related venous thromboembolism in anticoagulant factor-deficient women: Implications for prophylaxis. Annals of Internal Medicine 125: 955–960
Frosst P, Blom HJ, Milos R et al. (1995) A candidate genetic risk factor for vascular disease: a common mutation in methylenetetrahydrofolate reductase. Nat Genet 10: 111–113
Gerhardt A, Scharf RE, Zotz RB (2006) Risk of pregnancy-associated venous thromboembolism in women with a history of prior thrombosis. Blood (ASH Annual Meeting Abstracts) 108: Abstract 1493
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 Eng J Med 342: 374–380
Gerhardt A, Scharf RE, Zotz RB (2003) Effect of hemostatic risk factors on the individual probability of thrombosis during pregnancy and the puerperium. Thromb Haemost 90: 77–85
Gerhardt A, Zotz RB, Struve S, Scharf RE (2001) Homozygous and combined heterozygous factor V G1691A and prothrombin G20210A mutations as predictors of venous thrombosis during pregnancy. Thromb Haemost (Suppl) Abstract 2982
Gherman RB, Goodwin TM, Leung B, Byrne JD, Hethumumi R, Montoro M (1999) Incidence, clinical characteristics, and timing of objectively diagnosed venous thromboembolism during pregnancy. Obstet Gynecol 94: 730–734
Greer IA (1999) Thrombosis in pregnancy: maternal and fetal issues. Lancet 353: 1258–1265
Greer IA (2000) The challenge of thrombophilia in maternal-fetal medicine. N Eng J Med 342: 424–425
Greer IA, Nelson-Piercy C (2005) Low-molecular-weight heparins for thromboprophylaxis and treatment of venous thromboembolism in pregnancy: a systematic review of safety and efficacy. Blood 106: 401–407
Guyatt GH, Norris SL, Schulman S et al. (2012) Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 141: 53S–70S
Heit JA, Kobbervig CE, James AH, Petterson TM, Bailey KR, Melton LJI (2005) Trends in the incidence of venous thromboembolism during pregnancy or postpartum: a 30-year population-based study. Ann Intern Med 143: 697–706
Henriksson P, Westerlund E, Wallen H, Brandt L, Hovatta O, Ekbom A (2013) Incidence of pulmonary and venous thromboembolism in pregnancies after in vitro fertilisation: cross sectional study. BMJ 346: e8632
Jacobsen AF, Skjeldestad FE, Sandset PM (2008) Incidence and risk patterns of venous thromboembolism in pregnancy and puerperium - a register-based case-control study. Am J Obstet Gynecol 198: 233.e1–233.e7
James AH (2009) Venous thromboembolism in pregnancy. Arteriosclerosis Thrombosis and Vascular Biology 29: 326–331
James AH, Bushnell CD, Jamison MG, Myers ER (2005a) Incidence and risk factors for stroke in pregnancy and the puerperium. Obstet Gynecol 106: 509–516
James AH, Jamison MG, Biswas MS, Brancazio LR, Swamy GK, Myers ER (2006a) Acute myocardial infarction in pregnancy: a United States population-based study. Circulation 113: 1564–1571
James AH, Jamison MG, Brancazio LR, Myers ER (2006b) Venous thromboembolism during pregnancy and the postpartum period: incidence, risk factors, and mortality. Am J Obstet Gynecol 194: 1311–1315
James AH, Tapson VF, Goldhaber SZ (2005b) Thrombosis during pregnancy and the postpartum period. Am J Obstet Gynecol 193: 216–219
Kamphuisen PW, Eikenboom JC, Vos HL, Pablo R, Sturk A, Bertina RM, Rosendaal FR (1999) Increased levels of factor VIII and fibrinogen in patients with venous thrombosis are not caused by acute phase reactions. Thromb Haemost 81: 680–683
Khamashta MA, Cuadrado MJ, Mujic F, Taub NA, Hunt BJ, Hughes GRV (1995) The Management of Thrombosis in the Antiphospholipid-Antibody Syndrome. N Eng J Med 332: 993–997
Koster T, Blann AD, Briet E, Vandenbroucke JP, Rosendaal FR (1995) Role of clotting factor VIII in effect of von Willebrand factor on occurrence of deep-vein thrombosis. Lancet 345: 152–155
Koster T, Rosendaal FR, Reitsma PH, van der Velden PA, Briet E, Vandenbroucke JP (1994) Factor VII and fibrinogen levels as risk factors for venous thrombosis. A case-control study of plasma levels and DNA polymorphisms–the Leiden Thrombophilia Study (LETS). Thromb Haemost 71: 719–722
Kraaijenhagen RA, in’t Anker PS, Koopman MM, Reitsma PH, Prins MH, van den Ende A, Büller HR (2000) High plasma concentration of factor VIIIc is a major risk factor for venous thromboembolism. Thromb Haemost 83: 5–9
Kupferminc MJ, Eldor A, Steinman N, Many A, Bar-Am A, Jaffa A, Fait G, Lessing JB (1999) Increased frequency of genetic thrombophilia in women with complications of pregnancy. N Engl J Med 340: 9–13
Larsen TB, Sorensen HT, Gislum M, Johnsen SP (2007) Maternal smoking, obesity, and risk of venous thromboembolism during pregnancy and the puerperium: a population-based nested case-control study. Thromb Res 120: 505–509
Lepercq J, Conard J, Borel-Derlon A et al. (2001) Venous thromboembolism during pregnancy: a retrospective study of enoxaparin safety in 624 pregnancies. Brit J Ostet Gynaec 108: 1134–1140
Lindqvist P, Dahlback B, Marsal K (1999) Thrombotic risk during pregnancy: a population study. Obstet Gynecol 94: 595–599
Long AA, Ginsberg JS, BrillEdwards P et al. (1991) The Relationship of Antiphospholipid Antibodies to Thromboembolic Disease in Systemic Lupus-Erythematosus – A Cross-Sectional Study. Thromb Haemost 66: 520–524
Macklon NS, Greer IA (1996) Venous thromboembolic disease in obstetrics and gynaecology: The Scottish experience. Scottish Med J 41: 83–86
Martinelli I, Legnani C, Bucciarelli P, Grandone E, De Stefano V, Mannucci PM (2001) Risk of pregnancy-related venous thrombosis in carriers of severe inherited thrombophilia. Thromb Haemost 86: 800–803
McColl MD, Ellison J, Greer IA, Tait RC, Walker ID (2000a) Prevalence of the post-thrombotic syndrome in young women with previous venous thromboembolism. Br J Haematol 108: 272–274
McColl MD, Ellison J, Reid F, Tait RC, Walker ID, Greer IA (2000b) Prothrombin 20210 GA, MTHFR C677T mutations in women with venous thromboembolism associated with pregnancy. Brit J Ostet Gynaec 107: 565–569
McColl MD, Ramsay JE, Tait RC, Walker ID, McCall F, Conkie JA, Carty MJ, Greer IA (1997) Risk factors for pregnancy associated venous thromboembolism. Thromb Haemost 78: 1183–1188
McColl MD, Walker ID, Greer IA (1999) The role of inherited thrombophilia in venous thromboembolism associated with pregnancy. Brit J Ostet Gynaec 106: 756–766
Meijers JCM, Tekelenburg WLH, Bouma BN, Bertina RM, Rosendaal FR (2000) High levels of coagulation factor XI as a risk factor for venous thrombosis. N Eng J Med 342: 696–701
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. Brit J Haematol 113: 553–555
Miyakis S, Lockshin MD, Atsumi T et al. (2006) International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). Thromb Haemost 4: 295–306
O’Donnell J, Mumford AD, Manning RA, Laffan M (2000) Elevation of FVIII:C in venous thromboembolism is persistent and independent of the acute phase response. Thromb Haemost 83: 10–13
O’Donnell J, Tuddenham EG, Manning R, Kemball-Cook G, Johnson D, Laffan M (1997) High prevalence of elevated factor VIII levels in patients referred for thrombophilia screening: role of increased synthesis and relationship to the acute phase reaction. Thromb Haemost 77: 825–828
Pabinger I, Grafenhofer H, Kaider A, Kyrle PA, Quehenberger P, Mannhalter C, Lechner K (2005) Risk of pregnancy-associated recurrent venous thromboembolism in women with a history of venous thrombosis. Thromb Haemost 3: 949–954
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: 1060–1062
Pabinger I, Nemes L, Rintelen C et al. (2000) Pregnancy-associated risk for venous thromboembolism and pregnancy outcome in women homozygous for factor V Leiden. Hematol J 1: 37–41
Pabinger I, Schneider B (1996) Thrombotic risk in hereditary antithrombin III, protein C, or protein S deficiency - A cooperative, retrospective study. Arteriosclerosis Thrombosis and Vascular Biology 16: 742–748
Poort SR, Rosendaal FR, Reitsma PH, Bertina RM (1996) A common genetic variation in the 3’-untranslated region of the prothrombin gene is associated with elevated plasma prothrombin levels and an increase in venous thrombosis. Blood 88: 3698–3703
Ray JG, Chan WS (1999) Deep vein thrombosis during pregnancy and the puerperium: a meta-analysis of the period of risk and the leg of presentation. Obstetrical & Gynecological Survey 54: 265–271
Robertson L, Wu O, Langhorne P, Twaddle S, Clark P, Lowe GDO, Walker ID, Greaves M, Brenkel I, Regan L, Greer IA (2006) Thrombophilia in pregnancy: a systematic review. Brit J Haematol 132: 171–196
Rosendaal FR (1999) Venous thrombosis: a multicausal disease. Lancet 353: 1453–1457
Rosfors S, Noren A, Hjertberg R, Persson L, Lillthors K, Torngren S (2001) A 16-year haemodynamic follow-up of women with pregnancy-related medically treated iliofemoral deep venous thrombosis. Eur J Vasc Endovasc Surg 22: 448–455
Seligsohn U, Lubetsky A (2001) Medical progress: Genetic susceptibility to venous thrombosis. N Eng J Med 344: 1222–1231
Sibai BM (1999) Thrombophilias and adverse outcomes of pregnancy – what should a clinician do? N Engl J Med 340: 50–52
Simpson EL, Lawrenson RA, Nightingale AL, Farmer RD (2001) Venous thromboembolism in pregnancy and the puerperium: incidence and additional risk factors from a London perinatal database. BJOG 108: 56–60
Vlot AJ, Koppelman SJ, Bouma BN, Sixma JJ (1998) Factor VIII and von Willebrand factor. Thromb Haemost 79: 456–465
Ware JA, Coller BS (1995) Platelet morphology, biochemistry, and function. In: Beutler E, Lichtman MA, Coller S, Kipps TJ (eds.) Williams Hematology, 5th ed. New York: McGrawhill, p. 1161–1201
Zotz RB, Gerhardt A, Scharf RE (2003a) Inherited Thrombophilia and gestational venous thromboembolism. Best Pract Clin Haematol 16: 243–259
Zotz RB, Gerhardt A, Scharf RE (2003b) Prediction, prevention, and treatment of venous thromboembolic disease in pregnancy. Seminars in Thrombosis and Hemostasis 29: 143–153
Zotz RB, Gerhardt A, Scharf RE (2006) Venöse Thrombose in der Schwangerschaft. Hämostaseologie 26: 63–71
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Zotz, R., Gerhardt, A. (2014). Die Patientin mit thrombophiler Blutgerinnungsstörung. In: Gnoth, C., Mallmann, P. (eds) Perikonzeptionelle Frauenheilkunde. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-38023-5_16
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