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Thromboembolic Disease in Pregnancy

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181. Prevention of Thromboembolism in Spinal Cord Injury (Follow-up)

cord injury, and following the cessation of prophylactic anticoagulation therapy, to be lower than during the first 3 months after the injury, measuring 1.25% (eight out of 640 patients). [ ] For patient education information, see , as well as and . See also , , , , , , , and . Next: Etiopathophysiology Patients with spinal cord injury (SCI) have a higher risk of thromboembolic disease related to the Virchow triad (ie, venous stasis, hypercoagulability, intimal injury). Stasis from paralyzed (...) other tests for detecting DVT of the calf muscle, has less sensitivity and specificity than Doppler ultrasonography, and is less sensitive to incomplete obstruction of a vein by DVT. In addition, extrinsic compression may give a positive result. Radiologic Studies The following imaging studies may be used in the diagnosis of thromboembolic disease: radiocontrast venography, Doppler ultrasonography, I-125 fibrinogen scintigraphy, and ventilation/perfusion scanning. Radiocontrast venography

2014 eMedicine.com

182. Thromboembolism (Diagnosis)

disease, a ventriculoatrial shunt, trauma (especially fractures), cancer, surgery, infection, dehydration, shock, estrogen-containing contraceptives, pregnancy, smoking, and . (See Etiology.) [ ] The diagnosis and treatment of thrombosis in children were initially based on standards of care for adults. However, since the early 1990s, pediatric data have emerged that stress differences in thromboembolism etiology, pathophysiology, and anticoagulant drug pharmacokinetics in children. (See Etiology (...) that in pediatric trauma patients, independent risk factors for venous thromboembolism include older age, blood transfusion, surgery, a higher Injury Severity Score, and a lower Glasgow Coma Scale score. [ ] Use of arterial catheters The use of arterial catheters is the most common risk factor for arterial thromboembolism in children. Cardiac catheterization through the femoral artery to manage congenital heart disease is a frequent cause. Prophylaxis with heparin (100-150 U/kg) during the procedure lowers

2014 eMedicine Pediatrics

183. Prevention of Thromboembolism in Spinal Cord Injury (Diagnosis)

cord injury, and following the cessation of prophylactic anticoagulation therapy, to be lower than during the first 3 months after the injury, measuring 1.25% (eight out of 640 patients). [ ] For patient education information, see , as well as and . See also , , , , , , , and . Next: Etiopathophysiology Patients with spinal cord injury (SCI) have a higher risk of thromboembolic disease related to the Virchow triad (ie, venous stasis, hypercoagulability, intimal injury). Stasis from paralyzed (...) other tests for detecting DVT of the calf muscle, has less sensitivity and specificity than Doppler ultrasonography, and is less sensitive to incomplete obstruction of a vein by DVT. In addition, extrinsic compression may give a positive result. Radiologic Studies The following imaging studies may be used in the diagnosis of thromboembolic disease: radiocontrast venography, Doppler ultrasonography, I-125 fibrinogen scintigraphy, and ventilation/perfusion scanning. Radiocontrast venography

2014 eMedicine.com

184. Thromboembolism (Follow-up)

In pregnancy, establishing a clear guideline for the treatment of thromboembolic disease is difficult from an evidence-based perspective. Heparin is the anticoagulant of choice, given its relative safety for the fetus. Heparin therapy should be discontinued immediately before delivery, and then both heparin and warfarin therapy can be started post partum. Pregnant women with a history of previous thromboembolic disease probably should receive some prophylaxis, as the estimated range of recurrence is 0-15 (...) on the factors and cofactors of the coagulation cascade. Patients with acute, massive (PE) causing hemodynamic instability may be treated initially with a thrombolytic agent (eg, streptokinase or tissue plasminogen activator [t-PA]). t-PA has increasingly been used as the first-choice thrombolytic agent. Antibodies to streptokinase may be developed, limiting its use. Surgical interventions for venous thromboembolic disorders include thrombectomy and venous interruption. Special considerations Pregnancy

2014 eMedicine Surgery

185. Thromboembolism (Treatment)

In pregnancy, establishing a clear guideline for the treatment of thromboembolic disease is difficult from an evidence-based perspective. Heparin is the anticoagulant of choice, given its relative safety for the fetus. Heparin therapy should be discontinued immediately before delivery, and then both heparin and warfarin therapy can be started post partum. Pregnant women with a history of previous thromboembolic disease probably should receive some prophylaxis, as the estimated range of recurrence is 0-15 (...) on the factors and cofactors of the coagulation cascade. Patients with acute, massive (PE) causing hemodynamic instability may be treated initially with a thrombolytic agent (eg, streptokinase or tissue plasminogen activator [t-PA]). t-PA has increasingly been used as the first-choice thrombolytic agent. Antibodies to streptokinase may be developed, limiting its use. Surgical interventions for venous thromboembolic disorders include thrombectomy and venous interruption. Special considerations Pregnancy

2014 eMedicine Surgery

186. Thromboembolism (Overview)

disease, a ventriculoatrial shunt, trauma (especially fractures), cancer, surgery, infection, dehydration, shock, estrogen-containing contraceptives, pregnancy, smoking, and . (See Etiology.) [ ] The diagnosis and treatment of thrombosis in children were initially based on standards of care for adults. However, since the early 1990s, pediatric data have emerged that stress differences in thromboembolism etiology, pathophysiology, and anticoagulant drug pharmacokinetics in children. (See Etiology (...) that in pediatric trauma patients, independent risk factors for venous thromboembolism include older age, blood transfusion, surgery, a higher Injury Severity Score, and a lower Glasgow Coma Scale score. [ ] Use of arterial catheters The use of arterial catheters is the most common risk factor for arterial thromboembolism in children. Cardiac catheterization through the femoral artery to manage congenital heart disease is a frequent cause. Prophylaxis with heparin (100-150 U/kg) during the procedure lowers

2014 eMedicine Pediatrics

187. Management of Women with Obesity in Pregnancy

to women with a healthy pre-pregnancy weight, pregnant women with obesity are at increased risk of miscarriage, 6 gestational diabetes, 10 pre-eclampsia, 11 venous thromboembolism, 8,9 induced labour, 20 caesarean section, 17 anaesthetic complications 21,22 and wound infections, 10 and they are less likely to initiate or maintain breastfeeding. 18 Babies of obese mothers are at increased risk of stillbirth, 13 14 congenital anomalies, 7 prematurity, 23 macrosomia 10,15,20 and neonatal death. 14-16 (...) – 337.6) for antenatal venous thromboembolism (VTE) and 40.1 (95% CI 8.0–201.5) for postnatal VTE in women with a BMI =25 where there was evidence of immobilisation, compared with women with a BMI 40) (aOR 4.82, 95% CI 4.04–5.74). 15 Similar increases in risk have been reported for pregnancy induced hypertension and pre-eclampsia in an Australian cohort study, in which the incidence ranged from 2.4% in women with a BMI 19.8-26.0 to 14.5% (aOR 4.87, 95% CI 3.27– 7.24) in women with a BMI >40. 23

2010 Royal College of Obstetricians and Gynaecologists

188. Risk of thromboembolic disease in women taking oral contraceptives. A preliminary communication to the Medical Research Council by a Subcommittee. (PubMed)

Contraceptives, Oral adverse effects Coronary Disease chemically induced Female Humans Intracranial Embolism and Thrombosis chemically induced Middle Aged Phlebitis chemically induced Pregnancy Pulmonary Embolism chemically induced Retrospective Studies Thromboembolism chemically induced Thrombophlebitis chemically induced 1967 5 6 1967 5 6 0 1 1967 5 6 0 0 ppublish 6023133 PMC1841690 Br Med J. 1967 Mar 25;1(5542):726-9 6020089 Br Med J. 1965 Nov 13;2(5471):1164-6 5833621 (...) Risk of thromboembolic disease in women taking oral contraceptives. A preliminary communication to the Medical Research Council by a Subcommittee. 6023133 1967 06 23 2018 11 13 0007-1447 2 5548 1967 May 06 British medical journal Br Med J Risk of thromboembolic disease in women taking oral contraceptives. A preliminary communication to the Medical Research Council by a Subcommittee. 355-9 eng Journal Article England Br Med J 0372673 0007-1447 0 Contraceptives, Oral AIM IM Adolescent Adult

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1967 British medical journal

189. Oral contraceptives and thromboembolic disease. (PubMed)

Oral contraceptives and thromboembolic disease. 6023128 1967 06 23 2018 11 13 0007-1447 2 5548 1967 May 06 British medical journal Br Med J Oral contraceptives and thromboembolic disease. 327-8 eng Journal Article England Br Med J 0372673 0007-1447 0 Contraceptives, Oral AIM IM Adult Contraceptives, Oral adverse effects Female Humans Pregnancy Thromboembolism chemically induced 1967 5 6 1967 5 6 0 1 1967 5 6 0 0 ppublish 6023128 PMC1841739 Br Med J. 1966 May 28;1(5499):1327-8 5934376

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1967 British medical journal

190. Acute and recurrent thromboembolic disease: a new concept of etiology. (PubMed)

Acute and recurrent thromboembolic disease: a new concept of etiology. 5344031 1969 12 02 2018 11 13 0003-4932 170 4 1969 Oct Annals of surgery Ann. Surg. Acute and recurrent thromboembolic disease: a new concept of etiology. 547-58 Altemeier W A WA Hill E O EO Fullen W D WD eng Journal Article United States Ann Surg 0372354 0003-4932 9005-49-6 Heparin AIM IM Acute Disease Adult Aged Bacteroides Chronic Disease Female Fusobacterium Infections complications Heparin administration & dosage (...) therapeutic use Humans Infection microbiology L Forms pathogenicity Male Middle Aged Peptostreptococcus Pregnancy Pulmonary Embolism etiology Staphylococcal Infections complications Streptococcal Infections complications Thromboembolism etiology microbiology Thrombophlebitis etiology microbiology Varicose Veins complications 1969 10 1 1969 10 1 0 1 1969 10 1 0 0 ppublish 5344031 PMC1387770 Surgery. 1951 Aug;30(2):298-310 14855228 J Bacteriol. 1941 Mar;41(3):301-3 16560400 J Bacteriol. 1964 Dec;88:1805-7

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1969 Annals of Surgery

191. Oral contraception and thromboembolic disease. (PubMed)

Oral contraception and thromboembolic disease. 5652942 1968 07 29 2018 11 13 0008-4409 98 23 1968 Jun 08 Canadian Medical Association journal Can Med Assoc J Oral contraception and thromboembolic disease. 1117-8 eng Journal Article Canada Can Med Assoc J 0414110 0008-4409 0 Contraceptives, Oral AIM IM Adult Contraceptives, Oral adverse effects Female Humans Pregnancy Pulmonary Embolism etiology mortality Thromboembolism etiology mortality 1968 6 8 1968 6 8 0 1 1968 6 8 0 0 ppublish 5652942

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1968 Canadian Medical Association Journal

192. Oral contraceptives and thromboembolic disease. (PubMed)

Oral contraceptives and thromboembolic disease. 5648983 1968 07 04 2008 11 20 0007-1447 2 5601 1968 May 11 British medical journal Br Med J Oral contraceptives and thromboembolic disease. 366-7 Crawford J S JS eng Journal Article England Br Med J 0372673 0007-1447 0 Contraceptives, Oral AIM IM Contraceptives, Oral adverse effects Female Humans Pregnancy Thromboembolism chemically induced 1968 5 11 1968 5 11 0 1 1968 5 11 0 0 ppublish 5648983 PMC1985616

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1968 British medical journal

193. Oral contraception and thromboembolic disease. (PubMed)

Oral contraception and thromboembolic disease. 5676080 1968 11 01 2008 11 20 0008-4409 99 3 1968 Jul 20 Canadian Medical Association journal Can Med Assoc J Oral contraception and thromboembolic disease. 131 Whyte J C JC eng Journal Article Canada Can Med Assoc J 0414110 0008-4409 0 Contraceptives, Oral AIM IM Contraceptives, Oral adverse effects Female Humans Pregnancy Pregnancy Complications, Cardiovascular mortality Thromboembolism chemically induced mortality 1968 7 20 1968 7 20 0 1 1968 7

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1968 Canadian Medical Association Journal

194. Puerperal thromboembolic disease. (PubMed)

Puerperal thromboembolic disease. 4739604 1973 05 24 2018 11 13 0007-1447 1 5853 1973 Mar 10 British medical journal Br Med J Puerperal thromboembolic disease. 614 Taylor A B AB eng Journal Article England Br Med J 0372673 0007-1447 0 Iodine Radioisotopes AIM IM Animals Breast Female Humans Iodine Radioisotopes Milk Pregnancy Puerperal Disorders Radionuclide Imaging Thromboembolism diagnosis 1973 3 10 1973 3 10 0 1 1973 3 10 0 0 ppublish 4739604 PMC1589897 Br J Surg. 1968 Oct;55(10):742-7

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1973 British medical journal

195. An analysis of the reported association of oral contraceptives to thromboembolic disease. (PubMed)

An analysis of the reported association of oral contraceptives to thromboembolic disease. 1089003 1975 03 18 2018 11 13 0093-0415 122 1 1975 Jan The Western journal of medicine West. J. Med. An analysis of the reported association of oral contraceptives to thromboembolic disease. 26-33 Odell W D WD eng Journal Article Review United States West J Med 0410504 0093-0415 0 Contraceptives, Oral 0 Estrogens 731DCA35BT Diethylstilbestrol 88181ACA0M Norethynodrel B2V233XGE7 Mestranol IM Adolescent (...) Adult Cerebrovascular Disorders chemically induced Contraceptives, Oral adverse effects Diethylstilbestrol adverse effects therapeutic use Estrogens administration & dosage adverse effects therapeutic use Female Humans Intracranial Embolism and Thrombosis chemically induced mortality Male Mestranol adverse effects Myocardial Infarction chemically induced Norethynodrel adverse effects Pregnancy Prostatic Neoplasms drug therapy Pulmonary Embolism chemically induced mortality Recurrence Retrospective

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1975 Western Journal of Medicine

196. Maternal Comorbidities and Complications of Delivery in Pregnant Women With Congenital Heart Disease. (PubMed)

to 238.0), congestive heart failure (aOR: 49.1; 95% CI: 37.4 to 64.3), and coronary artery disease (aOR: 31.7; 95% CI: 21.4 to 47.0). Greater odds of adverse events were observed, including heart failure (aOR: 22.6; 95% CI: 20.5 to 37.3), arrhythmias (aOR: 12.4; 95% CI: 11.0 to 14.0), thromboembolic events (aOR: 2.4; 95% CI: 2.0 to 2.9), pre-eclampsia (aOR: 1.5; 95% CI: 1.3 to 1.7), and placenta previa (aOR: 1.5; 95% CI: 1.2 to 1.8). Cesarean section, induction, and operative vaginal delivery were more (...) Maternal Comorbidities and Complications of Delivery in Pregnant Women With Congenital Heart Disease. Pregnant women with congenital heart defects (CHDs) may be at increased risk for adverse events during delivery.This study sought to compare comorbidities and adverse cardiovascular, obstetric, and fetal events during delivery between pregnant women with and without CHDs in the United States.Comorbidities and adverse delivery events in women with and without CHDs were compared in 22,881,691

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2019 Journal of the American College of Cardiology

197. Sickle cell disease

, which is more likely to happen in certain conditions, such as: Intercurrent illness. Psychological stress. Cold temperatures. Pregnancy. Dehydration. Reduced oxygen in the blood, for example due to exertion, anaesthesia, and high altitude. of sickle cell disease increase with age and are becoming more common in high-income countries, as people live longer. They are as a result of infarction secondary to repeated vascular occlusion or chronic haemolysis. Sickle cell disease may also result in . Acute (...) exclusively in people with the sickle cell trait, and occasionally in people with sickle cell disease [ ; ; ]. It is aggressive and has usually metastasized by the time the symptoms (weight loss, fever, haematuria, flank pain, and abdominal pain) have occurred [ ]. [ ; ; ; ; ; ; ; ; ] Complications in pregnancy What are the complications of sickle cell disease during pregnancy? In women with sickle cell disease, pregnancy may: Make anaemia worse. Increase the risk of painful crises, including acute chest

2017 NICE Clinical Knowledge Summaries

198. Thromboembolic Disorders in Pregnancy

in stasis. Pregnancy causes a degree of hypercoagulability. However, most thromboemboli develop postpartum and result from vascular trauma during delivery. The risk of developing a may be increased for about 6 weeks after delivery. Cesarean delivery also increases risk. Symptoms of thrombophlebitis or their absence does not accurately predict the diagnosis, disease severity, or risk of embolization. Thromboembolic disorders can occur without symptoms, with only minimal symptoms, or with significant (...) Thromboembolic Disorders in Pregnancy Thromboembolic Disorders in Pregnancy - Gynecology and Obstetrics - MSD Manual Professional Edition Brought to you by The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases / / / / IN THIS TOPIC OTHER TOPICS IN THIS CHAPTER

2013 Merck Manual (19th Edition)

199. Congenital Heart Disease in the Older Adult

arrhythmias, connective tissue disease, and familial aortic aneurysm. Issues related to contraception and pregnancy will not be addressed in this document, although we recognize that some women >40 years of age may still have child-bearing potential. The writing group was charged with the task of performing an evidence-based assessment of the data and providing a class of recommendation and a level of evidence to each recommendation according to the ACC/AHA classification system ( ). Table 1. Applying (...) Congenital Heart Disease in the Older Adult Congenital Heart Disease in the Older Adult | Circulation Search Hello Guest! Login to your account Email Password Keep me logged in Search March 2019 March 2019 March 2019 March 2019 March 2019 February 2019 February 2019 February 2019 February 2019 January 2019 January 2019 January 2019 January 2019 January 2019 This site uses cookies. By continuing to browse this site you are agreeing to our use of cookies. Free Access article Share on Jump to Free

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2015 American Heart Association

200. Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence

Consortium reported a 4.3% incidence of major adverse events in the early postoperative period. Although these reports are encouraging, a number of complications associated with bariatric surgery are potentially fatal and merit careful consideration. The most common complications are summarized in . Table 7. Complications of Bariatric Surgery Complications Frequency, %, and Outcomes Sepsis from anastomotic leak 1–2 Hemorrhage 1–4 Cardiopulmonary events … Thromboembolic disease 0.34 Late complications (...) Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence | Circulation Search Hello Guest! Login to your account Email Password Keep me logged in Search March 2019 March 2019 March 2019 March 2019 March 2019 February 2019 February 2019 February 2019 February 2019 January 2019 January 2019 January 2019 January 2019 January

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2015 American Heart Association

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