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Thromboembolic Disease in Pregnancy

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181. Anticoagulation in Thromboembolism

Anticoagulation in Thromboembolism Anticoagulation in Thromboembolism Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Anticoagulation (...) in Thromboembolism Anticoagulation in Thromboembolism Aka: Anticoagulation in Thromboembolism , Pulmonary Embolism Anticoagulation , Deep Vein Thrombosis Anticoagulation , PE Anticoagulation , DVT Anticoagulation From Related Chapters II. Disposition Inpatient (typical) or if criteria met, outpatient Inpatient or outpatient management depending on risk See III. Labs Initial labs Polycythemia, ,associated with (myeloproliferative disorder) (INR) (PTT) Increased PTT without correction by 1:1 dilution with normal

2018 FP Notebook

182. Thromboembolism Risk Factors

: Initial Venous Thromboembolism by chronicity Major transient risks Hospitalization Plaster cast immobilization Surgery Minor transient risks Prolonged travel >2 hours (risk increases 18% for every 2 hours traveled) Pregnancy s or other hormone therapy Persistent risks Collagen vascular disease Cancer Myeloproliferative disorders VI. Risk Factors: Recurrent Thromboembolism after stopping Anticoagulants (Relative Risk) Metastatic cancer (6-9) Factor VIII >200 IU/dl (6) Non-metastatic Cancer (3) (2.5 (...) cause found in up to one third of DVT cases Prior (DVT) Medications Increased or Pregnancy (Nolvadex) Phenothiazines Major Recent Surgery (e.g. ) Cancer Consider evaluation for occult cancer in DVT Polycythemia History of thromboembolic disease Deep Venous Thrombosis Type A Blood IX. Risk Factors: Intimal damage Local Surgery (Especially ral and Orthopedic Surgery) ral anesthesia is an independent risk factor Consider Penetrating vessel injury Especially femoral X. References Images: Related links

2018 FP Notebook

183. Maternal Collapse in Pregnancy and the Puerperium

, Placenta Praevia Accreta and Vasa Praevia: Diagnosis and Management. 67 4.6.2 Venous thromboembolism The specific management of massive pulmonary embolism is covered in the RCOG Green-top Guideline No. 28: Thromboembolic Disease in Pregnancy and the Puerperium: Acute Management. 68 4.6.3 Amniotic fluid embolism The management of AFE is supportive rather than specific, as there is no proven effective therapy. 2 12 of 24 RCOG Green-top Guideline No. 56 © Royal College of Obstetricians and Gynaecologists (...) 4. Clinical issues 4.1 Can women at risk of impending collapse be identified early? An obstetric early warning score chart should be used routinely for all women, to allow early recognition of the woman who is becoming critically ill. In some cases maternal collapse occurs with no prior warning, although there may be existing risk factors that make this more likely. Antenatal care for women with significant medical conditions at risk of maternal collapse should include multidisciplinary team

2011 Royal College of Obstetricians and Gynaecologists

184. Antepartum dalteparin versus no antepartum dalteparin for the prevention of pregnancy complications in pregnant women with thrombophilia (TIPPS): a multinational open-label randomised trial. (Abstract)

Antepartum dalteparin versus no antepartum dalteparin for the prevention of pregnancy complications in pregnant women with thrombophilia (TIPPS): a multinational open-label randomised trial. Thrombophilias are common disorders that increase the risk of pregnancy-associated venous thromboembolism and pregnancy loss and can also increase the risk of placenta-mediated pregnancy complications (severe pre-eclampsia, small-for-gestational-age infants, and placental abruption). We postulated (...) that antepartum dalteparin would reduce these complications in pregnant women with thrombophilia.In this open-label randomised trial undertaken in 36 tertiary care centres in five countries, we enrolled consenting pregnant women with thrombophilia at increased risk of venous thromboembolism or with previous placenta-mediated pregnancy complications. Eligible participants were randomly allocated in a 1:1 ratio to either antepartum prophylactic dose dalteparin (5000 international units once daily up to 20 weeks

2014 Lancet Controlled trial quality: predicted high

185. A systematic review and meta-analysis assessing the risk of venous thromboembolism in pregnant women with essential thrombocythemia

A systematic review and meta-analysis assessing the risk of venous thromboembolism in pregnant women with essential thrombocythemia Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne (...) studies per subgroup is required. ">Subgroup analyses A sensitivity analysis is conducted to assess the impact of decisions taken in the review process on the meta-analysis outcome. These decisions may have been made in various stages of the review, e.g. the decision to exclude certain disease models, the decision to pool certain units of measurement for an outcome, the choice of effect measure, how subgroup variables are stratified etc. In order to assess the robustness of the findings of the meta

2016 PROSPERO

186. The Society for Obstetric Anesthesia and Perinatology Consensus Statement on the Anesthetic Management of Pregnant and Postpartum Patients on Venous Thromboembolism (VTE) prophylaxis

The Society for Obstetric Anesthesia and Perinatology Consensus Statement on the Anesthetic Management of Pregnant and Postpartum Patients on Venous Thromboembolism (VTE) prophylaxis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email (...) no). For stratified analyses, a minimum number of 8 studies per subgroup is required. ">Subgroup analyses A sensitivity analysis is conducted to assess the impact of decisions taken in the review process on the meta-analysis outcome. These decisions may have been made in various stages of the review, e.g. the decision to exclude certain disease models, the decision to pool certain units of measurement for an outcome, the choice of effect measure, how subgroup variables are stratified etc. In order to assess

2016 PROSPERO

187. Canadian Association of Gastroenterology Clinical Practice Guideline for the Medical Management of Pediatric Luminal Crohn’s Disease

or methotrexate, we recommend anti-TNF therapy to induce and maintain clinical remission. GRADE: Strong recommendation, high-quality evidence. Vote: strongly agree, 93%; agree, 7%. Recommendation 19: In patients with severe inflammatory CD judged at risk for progressive, disabling disease, we suggest anti-TNF therapy as first-line therapy to induce and maintain clinical remission. GRADE: Conditional recommendation, very-low-quality evidence. Vote: strongly agree, 47%; agree, 53%. Recommendation 20: When (...) , the consensus group concluded that there was insufficient evidence to warrant routine use of sulfasalazine in pediatric patients with moderate disease. Although the statement suggested against sulfasalazine, it was conditional because of the trend toward efficacy in colonic disease, which is the location targeted by sulfasalazine. Similar to 5-ASA, given the potential efficacy of sulfasalazine in mild disease and the fact that treatment delays may be of less concern in such patients, the consensus group did

2019 Canadian Association of Gastroenterology

188. Canadian Association of Gastroenterology Clinical Practice Guideline for the Management of Luminal Crohn’s Disease

: TNF; 5-ASA; Guidance; Mucosal Healing Crohn’s disease (CD) is a lifelong illness with substantial mor- bidity and mortality. Studies have shown that up to one-third of patients require hospitalization within the first year after diagnosis and more than half within 5 years. 1 In addition to in- creased risk of mortality from digestive conditions, CD is also associated with a significantly increased risk of all-cause mortal - ity compared with the general population (standardized mor- tality ratio (...) -first authorship. Abstract Background & Aims: Crohn’s disease (CD) is a lifelong illness with substantial morbidity, although new therapies and treatment paradigms have been developed. We provide guidance for treatment of ambulatory patients with mild to severe active luminal CD. Methods: We performed a systematic review to identify published studies of the management of CD. The quality of evidence and strength of recommendations were rated according to the Grading of Recommendation Assessment

2019 Canadian Association of Gastroenterology

189. Screening and Management of Bleeding Disorders in Adolescents With Heavy Menstrual Bleeding

antigens may reduce the risk of hemolytic disease of the newborn in any future pregnancy. Transfusion guidelines developed by the Eastern Association for Surgery of Trauma, the American College of Critical Care Medicine, and the Society of Critical Care Medicine advocate for restrictive red blood cell transfusion practices and transfusion only for a hemoglobin of 7g/dL or less to limit complications of allogenic transfusions ( ). Studies of restrictive transfusion practices in critically ill children (...) obtaining a medical history, it is important to identify risk factors for bleeding disorders as well as medical conditions that would alter management. Physical examination of the patient who presents with acute heavy menstrual bleeding should include assessment of hemodynamic stability, including orthostatic blood pressure and pulse measurements. In adolescent girls with heavy menstrual bleeding, speculum examination typically is not required. Evaluation of adolescent girls who present with heavy

2019 American College of Obstetricians and Gynecologists

190. Management of Irritable Bowel Syndrome (IBS)

be performed only once, and if negative, patients do not require a gluten-free diet (GFD). Key evidence: There was very-low quality evidence on the role of testing for C-reactive protein (CRP) in IBS patients from a Statement 1: We suggest IBS patients have serological testing to exclude celiac disease. GRADE: Conditional recommendation, low-quality evidence. Vote: strongly agree, 50%; agree, 50% Statement 2: We recommend AGAINST testing for CRP in IBS patients to exclude inflammatory disorders. GRADE (...) Division of Gastroenterology, University of T oronto, T oronto, Ontario, Canada; 10 Division of Gastroenterology, Queen’s University, Kingston, Ontario, Canada Correspondence: Dr. Paul Moayyedi, BSc, MB, ChB, PhD, MPH, FRCP , FRCPC, AGAF, FACG, Director, Division of Gastroenterology, McMaster University, 1280 Main St. W . HSC 3V3, Hamilton, ON, Canada L8S 4K1, E-mail: moayyep@mcmaster.ca ABSTRACT Background & aims: Irritable bowel syndrome (IBS) is one of the most common gastrointestinal (GI) disorders

2019 Canadian Association of Gastroenterology

191. Heart Disease and Stroke Statistics Full Text available with Trip Pro

. Physical Inactivity e99 5. Nutrition e119 6. Overweight and Obesity e138 Health Factors and Other Risk Factors 7. High Blood Cholesterol and Other Lipids e161 8. High Blood Pressure e174 9. Diabetes Mellitus e193 10. Metabolic Syndrome e212 11. Kidney Disease e233 12. Sleep e249 Cardiovascular Conditions/Diseases 13. Total Cardiovascular Diseases e257 14. Stroke (Cerebrovascular Disease) e281 15. Congenital Cardiovascular Defects and Kawasaki Disease e327 16. Disorders of Heart Rhythm e346 17. Sudden (...) Cardiac Arrest, Ventricular Arrhythmias, and Inherited Channelopathies e377 18. Subclinical Atherosclerosis e401 19. Coronary Heart Disease, Acute Coronary Syndrome, and Angina Pectoris e415 20. Cardiomyopathy and Heart Failure e438 21. Valvular Diseases e455 22. Venous Thromboembolism (Deep Vein Thrombosis and Pulmonary Embolism), Chronic Venous Insufficiency, Pulmonary Hypertension e472 23. Peripheral Artery Disease and Aortic Diseases e481 Outcomes 24. Quality of Care e497 25. Medical Procedures

2019 American Heart Association

192. AIM Clinical Appropriateness Guidelines for Pharmacogenetic Testing and Genetic Testing for Thrombotic Disorders

genotyping assays in which each included target does not meet the above criteria are not medically necessary. Thrombophilia Testing Testing for common variants in Factor V Leiden (F5) and prothrombin (F2) is medically necessary for any of the following indications: • Pregnant woman who has a personal history of an unprovoked venous thromboembolism (VTE) (e.g. not associated with fracture, surgery, prolonged immobilization, cancer) • In an individual with an unprovoked VTE when test results will impact (...) medication is recognized, there are many variables in the pharmacokinetics and pharmacodynamics of medications. To date, there is a lack of large, controlled studies that address whether the use of pharmacogenomic panels in prescribing medications improves outcomes (Drozda et al. 2014). Thrombophilia Testing Thrombophilia describes a state of hypercoagulability that leads to an increased risk of thrombotic events. Venous thromboembolism (VTE) is a common, complex disease associated with both

2019 AIM Specialty Health

193. Characteristics, Prevention, and Management of Cardiovascular Disease in People Living With HIV: A Scientific Statement From the American Heart Association

and statins among high-risk individuals. The decision of what ART to start and whether to switch because of comorbidities or side effects is complex and depends on many factors, including cardiovascular risk assessment, HLA-B*57:01 testing (for hypersensitivity to abacavir), HIV resistance testing, medication compliance, pregnancy/child-bearing age, and other comorbidities such as bone and renal disease. Atherosclerosis Pathophysiology in HIV: Hypertension, Smoking, and Other Factors Other traditional (...) and hypertension should be managed as recommended for the general population because there are insufficient data to recommend a divergent approach in HIV. A practical expert consensus approach to ASCVD risk assessment and primary prevention in HIV that is based on available (albeit incomplete) evidence is provided in . Acute Coronary Syndromes and Secondary Prevention of Coronary Artery Disease PLWH who experience an acute coronary syndrome such as ST-segment–elevation and non–ST-segment–elevation MI tend

2019 American Heart Association

194. Use of Psychotropic Medications Among Pregnant Women With Bipolar Disorder

polytherapy in pregnant women diagnosed with bipolar disorder. To assess the impact of antipsychotics, antidepressants, and antipsychotic-antidepressant polytherapy on the risk of maternal, neonatal, and labour and delivery outcomes in women with bipolar disorder. To assess the impact of antipsychotics, antidepressants, antipsychotic-antidepressant polytherapy on psychiatric readmission rates during the early postpartum period in women with bipolar disorder. Condition or disease Intervention/treatment (...) Bipolar Disorder Pregnancy Complications Drug: Antipsychotic Drug: Antidepressant Drug: Antipsychotic and Antidepressant Study Design Go to Layout table for study information Study Type : Observational Actual Enrollment : 3357 participants Observational Model: Cohort Time Perspective: Retrospective Official Title: Use of Psychotropic Medications Among Pregnant Women With Bipolar Disorder: Patterns, Determinants, and Impact on Perinatal Outcomes Study Start Date : September 2016 Actual Primary

2016 Clinical Trials

195. Enoxaparin in the Prevention of Placental Insufficiency in Pregnant Women

by (Responsible Party): Les Laboratoires des Médicaments Stériles Study Details Study Description Go to Brief Summary: Assessment of the effectiveness of Enoxaparin, at a preventive dose, combined with Aspirin treatment versus Aspirin only treatment in reducing placental insufficiency in pregnant women. Condition or disease Intervention/treatment Phase Placental Insufficiency Enoxaparin Drug: Enoxaparin 40 mg / 0.4 mL Prefilled Syringe Drug: Aspirin 100 mg Oral Tablet, Enteric Coated Phase 4 Detailed (...) Single and confirmed pregnancy Intrauterine growth restriction (IUGR) history with an estimated fetal weight (ESW) < 3rd percentile In utero fetal death (IUFD) history > 12 weeks of amenorrhea (WA) Central Retroplacental hematoma (RPH) history < 34 WA History of severe preeclampsia < 34 WA Informed consent, written and obtained Exclusion Criteria: Age <18 years Age > 45 years Multiple pregnancy Pregnancy > 7 WA Positive immunological assessment Known history of Thromboembolic diseases, Hemorrhagic

2018 Clinical Trials

196. Overcoming heparin resistance in pregnant women with antithrombin deficiency: a case report and review of the literature Full Text available with Trip Pro

Overcoming heparin resistance in pregnant women with antithrombin deficiency: a case report and review of the literature The risk of thromboembolic events during pregnancy in patients with antithrombin deficiency is increased. Preventing thromboembolic events during pregnancy in the case of antithrombin deficiency is still a matter of concern.We present a case of a 19-year-old primigravida Greek Pomak woman, who was diagnosed as having congenital antithrombin deficiency. She had a history (...) risk of venous thromboembolic events with a 50% risk of thromboembolic events before the 50th year of life. It is a rare condition, so data concerning the optimal management during pregnancy are limited. The selection of patients who should receive low molecular weight heparin prophylaxis as well as dose intensity and monitoring are discussed. In our patient a conventional low molecular weight heparin dose proved to be inadequate at least at the laboratory level.

2018 Journal of medical case reports

197. Cardiovascular Health in Turner Syndrome: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

Pregnancy Pregnancy in women with TS is associated with significant risks, including hypertensive disorders, preeclampsia, premature birth, low birth weight, and need for cesarean delivery. Pregnancy in Marfan syndrome increases the risk of AoD or rupture. Case reports, but no controlled studies to date, suggest that pregnancy may increase the AoD risk in TS. Structural changes in the intima and media have been described in pregnant women without aortic disease. Histopathology previously showed (...) conclusions to be drawn. Patients derived from these reports may overrepresent those with unusual presentations of their disease. In the GenTAC study (Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions) of 278 pregnancies in women with Marfan syndrome, an 8-fold increased risk of AoD was reported. In addition, a population-based registry from Sweden reported a 25-fold increased risk of AoD related to pregnancy in TS. ART may pose additional risk for significant complications

2018 American Heart Association

198. Treatment for Bipolar Disorder in Adults: A Systematic Review

Appendix P. Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) and Other Psychosocial and Somatic Interventions Appendix Q. Harms Tables ES-1 Evidence Summary Background Bipolar disorder (BD), also known as manic-depressive illness, is a serious mental illness that causes unusual shifts in mood, energy, activity levels, and the inability to carry out day-to- day tasks. The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) recognizes a spectrum of bipolar (...) episodes of mania and depression can cause serious impairments in functioning, such as erratic work performance, increased divorce rates, and psychosocial morbidity. 3, 4 People with bipolar disorder account for between 3 and 14 percent of all suicides, and about 25 percent of bipolar disorder patients will attempt suicide. 5 Further adding to the individual illness burden, 92 percent of individuals with BD experience another co-occurring psychiatric illness during their lifetime. 6 Of all psychiatric

2018 Effective Health Care Program (AHRQ)

199. Adults With Congenital Heart Disease

. Echocardiography 27 3.4.4. CMR Imaging 28 3.4.5. Cardiac Computed Tomography 29 3.4.6. Cardiac Catheterization 30 3.4.7. Exercise Testing 31 3.5. Transition Education 31 3.6. Exercise and Sports 32 3.7. Mental Health and Neurodevelopmental Issues 34 3.8. Endocarditis Prevention 34 3.9. Concomitant Syndromes 35 3.10. Acquired Cardiovascular Disease 36 3.11. Noncardiac Medical Issues 37 3.12. Noncardiac Surgery 37 3.13. Pregnancy, Reproduction, and Sexual Health 39 3.13.1. Pregnancy 39 3.13.2. Contraception 41 (...) data and growing ACHD expertise to develop recommendations. Congenital heart disease (CHD) encompasses a range of structural cardiac abnormalities present before birth attributable to abnormal fetal cardiac development but does not include inherited disorders that may have cardiac manifestations such as Marfan syndrome or hypertrophic cardiomyopathy. Also not included are anatomic variants such as patent foramen ovale. Valvular heart disease (VHD) may be congenital, so management overlaps

2018 American College of Cardiology

200. Management of Valvular Heart Disease Full Text available with Trip Pro

2746 3.7 Management of associated conditions 2747 3.7.1 Coronary artery disease 2747 3.7.2 Atrial fibrillation 2747 4. Aortic regurgitation 2748 4.1 Evaluation 2748 4.1.1 Echocardiography 2748 4.1.2 Computed tomography and cardiac magnetic resonance 2749 4.2 Indications for intervention 2749 4.3 Medical therapy 2751 4.4 Serial testing 2751 4.5 Special patient populations 2751 5. Aortic stenosis 2751 5.1 Evaluation 2751 5.1.1 Echocardiography 2751 5.1.2 Additional diagnostic aspects, including (...) Aortic stenosis 2778 12.2.2 Mitral stenosis 2778 12.2.3 Aortic and mitral regurgitation 2778 12.3 Perioperative monitoring 2779 13. Management during pregnancy 2779 13.1 Native valve disease 2779 13.2 Prosthetic valves 2779 14. To do and not to do messages from the Guidelines 2780 15. What is new in the 2017 Valvular Heart Disease Guidelines? 2782 16. Appendix 2784 17. References 2785 Abbreviations and acronyms ΔPm Mean transvalvular pressure gradient 2D Two-dimensional 3D Three-dimensional ABC Age

2017 European Society of Cardiology

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