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Thromboembolic Disease in Pregnancy

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41. CRACKCast E178 – Co-Morbird Medical Emergencies During Pregnancy

are the most common types of valvular disease (63%), followed by aortic valve disease (23%). The most common valvular complication in pregnancy is heart failure (challenging dx to make in pregnancy!) When it comes to prosthetic valves, these women are at high risk for clotting (hypercoagulable state) as well as thromboembolic phenomenon! Pregnant patients with prosthetic heart valves who are not anticoagulated have a maternal mortality as high as 5%, and thromboembolic events can occur in up to 24 (...) in an increased incidence of thromboembolic disease, with the incidence of deep vein thrombosis (DVT) reported as high as 8% in pregnant women with SCI. The incidence of urinary tract infection is also markedly increased as a result of neurogenic complications and the need for catheterization. Infections are even more likely during pregnancy and may progress to pyelonephritis, with the subsequent increased risk of fetal loss, prematurity, and maternal sepsis. [8] What is autonomic dysreflexia? How

2018 CandiEM

42. Management of Pregnancy

schedules. Federal laws addressing breastfeeding in the workplace exist but are relatively new.[ ] 11 In contrast, the infant mortality rate has declined 15% between 2005 and 2015, from 6.86 infant deaths per 1,000 live births to 5.82.[ ] The Centers for Disease Control and Prevention (CDC) indicated the following were the five leading causes of infant death in 2014:[ ] 12 13 • Birth defects • Preterm birth or low birth weight • Maternal complications of pregnancy • Sudden infant death syndrome (SIDS (...) Management of Pregnancy VA/DOD CLINICAL PRACTICE GUIDELINE FOR THE MANAGEMENT OF PREGNANCY Department of Veterans Affairs Department of Defense QUALIFYING STATEMENTS The Department of Veterans Affairs and the Department of Defense guidelines are based upon the best information available at the time of publication. They are designed to provide information and assist decision making. They are not intended to define a standard of care and should not be construed as one. Neither should

2018 VA/DoD Clinical Practice Guidelines

43. Venous Thromboembolism Risk and Adequacy of Prophylaxis in High Risk Pregnancy in the Arabian Gulf Full Text available with Trip Pro

Venous Thromboembolism Risk and Adequacy of Prophylaxis in High Risk Pregnancy in the Arabian Gulf To estimate the prevalence of venous thromboembolism (VTE) risk factors in pregnancy and the proportion of pregnancies at risk of VTE that received the recommended prophylaxis according to the American College of Chest Physicians (ACCP) 2012 published guidelines in antenatal clinics in the Arabian Gulf.The evaluation of venous thromboembolism (EVE)-Risk project was a non-interventional, cross (...) (6.9%), thrombophilia (2.6%), immobilization (2.0%), sickle cell disease (2.8%) and previous VTE (1.6%). Only 8.3% (n=111) of the high risk patients were on the recommended VTE prophylaxis. Enoxaparin was used in 80% (n=89) of the cases followed by tinzaparin (4%; n=4). Antiplatelet agents were prescribed in 11% (n=149) of pregnant women. Of those on anticoagulants (n=111), 59% (n=66) were also co-prescribed antiplatelet agents. Side effects (mainly local bruising at the injection site) were

2016 Current vascular pharmacology

44. Thrombophilia and venous thromboembolism in pregnancy: a meta-analysis of genetic risk. (Abstract)

Thrombophilia and venous thromboembolism in pregnancy: a meta-analysis of genetic risk. Three common polymorphic variants, namely Factor V Leiden (FVL), Prothrombin G20210A (PT G20210A) and Methylenetetrahydrofolate Reductase (MTHFR) C677T are candidate genes for venous thromboembolism (VTE) in pregnancy. We performed a literature review and meta-analysis of pertinent genetic association studies (GAS) in pregnancy, to quantify the genetic risk of VTE in pregnancy. We used the model-free (...) approach of generalized odds ratio (ORG) to estimate gene-to-disease association and explored the mode of inheritance using the degree of dominance h index. Twelve case-control GAS studies provided the full genotype distributions for at least one candidate gene to assess the genetic risk. FVL was associated with a significant risk of VTE in pregnancy (ORG 7.28; 95% confidence interval 5.53-9.58) and a dominant mode of inheritance (h=0.76), that is the effect of heterozygous carriers will lie close

2015 European journal of obstetrics, gynecology, and reproductive biology

45. Incidence of venous thromboembolism during pregnancy and the puerperium: a systematic review and meta-analysis. (Abstract)

Incidence of venous thromboembolism during pregnancy and the puerperium: a systematic review and meta-analysis. Women during pregnancy or puerperium have a higher risk of venous thromboembolism (VTE). The reported incidence of pregnancy-associated VTE from literature varied considerably. To summarize the overall incidence of the disease, we conducted this meta-analysis.We searched PubMed, EMBase and CNKI (China National Knowledge Infrastructure) for studies that reported the incidence of VTE (...) during pregnancy or puerperium. The quality of included studies was assessed using the Newcastle-Ottawa scale and the meta-analysis was conducted using R software and Meta analyst Beta 3.13. Sensitivity analyses were performed to analyze the robustness of the results and publication bias was assessed using Egger's test.Twenty-seven articles met the inclusion criteria. The pooled incidence rate was 1.4‰ (1.0-1.8‰) for VTE, 1.1‰ (1.0-1.3‰) for deep vein thrombosis (DVT) and 0.3‰ (0.2-0.4

2015 The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians

46. ASPIRE: Low?Dose Aspirin for Preventing Recurrent Venous Thromboembolism

= Peptic Ulcer Disease ,TIA= Transient ischemic attack, USA= Unstable angina, Vitamin K antagonist=Warfarin, VKA=Vitamin K antagonist, VTE=Venous Thromboembolism, Yr=Year DISCLAIMER: The content of this newsletter represents the research, experience and opinions of the authors and not those of the Board or Administration of Saskatoon Health Region (SHR). Neither the authors nor Saskatoon Health Region nor any other party who has been involved in the preparation or publication of this work warrants (...) ASPIRE: Low?Dose Aspirin for Preventing Recurrent Venous Thromboembolism RXFILES TRIAL SUMMARY MATTHEW SWANKHUIZEN – MAY 2013 – WWW.RXFILES.CA Page 1 of 2 ASPIRE: Low-Dose Aspirin for Preventing Recurrent Venous Thromboembolism 1 Aspirin to Prevent Recurrent Venous Thromboembolism BOTTOM LINE • In patients whom have had an unprovoked VTE with low to moderate bleed risk the addition of ASA 100 mg daily is reasonable to prevent future VTE events and major vascular events if the decision is made

2013 RxFiles

47. Cardiac Diseases With Pregnancy in Benisuef Localities

Cardiac Diseases With Pregnancy in Benisuef Localities Cardiac Diseases With Pregnancy in Benisuef Localities - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Cardiac Diseases With Pregnancy in Benisuef (...) Enrollment : 400 participants Observational Model: Other Time Perspective: Prospective Target Follow-Up Duration: 2 Years Official Title: Cardiac Diseases With Pregnancy in Benisuef Localities Study Start Date : January 2015 Actual Primary Completion Date : December 2016 Actual Study Completion Date : December 2016 Resource links provided by the National Library of Medicine related topics: (AHRQ) related information: Groups and Cohorts Go to Group/Cohort Intervention/treatment cardiac patients WHO class

2017 Clinical Trials

48. A case of successfully managed pregnancy in a patient with complex cyanotic congenital heart disease Full Text available with Trip Pro

A case of successfully managed pregnancy in a patient with complex cyanotic congenital heart disease Medical advances have increased survival of patients with congenital heart disease. However, cardiac disease in pregnancy carries significant maternal and fetal risks, posing enormous challenges to obstetricians. Cyanotic congenital heart disease is associated with maternal complications such as arrhythmias, thromboembolic events and death. Fetal complications include small for gestational age (...) , miscarriage and prematurity. Cyanotic congenital heart disease patients who continue their pregnancies require holistic multidisciplinary team care with early and coordinated planning for delivery. Management of such patients include early counseling regarding pregnancy-associated risks, close monitoring of their cardiac function and regular scanning for fetal assessment. Choice of anesthesia for these patients requires meticulous planning to achieve a favorable balance between systemic and pulmonary

2016 Obstetric medicine

49. Influence of socioeconomic factors on pregnancy outcome in women with structural heart disease. Full Text available with Trip Pro

Influence of socioeconomic factors on pregnancy outcome in women with structural heart disease. Cardiac disease is the leading cause of indirect maternal mortality. The aim of this study was to analyse to what extent socioeconomic factors influence the outcome of pregnancy in women with heart disease.The Registry of Pregnancy and Cardiac disease is a global prospective registry. For this analysis, countries that enrolled ≥10 patients were included. A combined cardiac endpoint included maternal (...) adjustment for patient characteristics, Gini and country-specific birth rate.While there are definite interregional differences in pregnancy outcome in women with cardiac disease, these differences seem to be mainly driven by individual patient characteristics. Adjustment for country characteristics refined the results to a limited extent, but maternal condition seems to be the main determinant of outcome.© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018

2017 Heart

50. Guidelines for the Use of Laparoscopy during Pregnancy

cholelithiasis, adrenal tumors, splenic disorders, symptomatic hernias, complications of inflammatory bowel diseases, and other rare conditions Over two decades ago, some argued that laparoscopy was contraindicated during pregnancy due to concerns for uterine injury from trocar placement and fetal malperfusion due to pneumoperitoneum. As surgeons gained more experience and documented their outcomes, laparoscopy has become the preferred treatment modality for many surgical diseases in the gravid patient [5, 6 (...) in the pregnant patient include decreased fetal respiratory depression due to diminished postoperative narcotic requirements [77, 81-83] , lower risk of wound complications [81, 84, 85] , diminished postoperative maternal hypoventilation [81, 82] , and decreased risk of thromboembolic events. The improved visualization in laparoscopy may reduce the risk of uterine irritability by decreasing the need for uterine manipulation [86] . Laparoscopy and Trimester of Pregnancy Guideline 9: Laparoscopy can be safely

2017 Society of American Gastrointestinal and Endoscopic Surgeons

51. Quality measures in high-risk pregnancies: Executive summary of a cooperative workshop of SMFM, NICHD, and ACOG Full Text available with Trip Pro

as a quality measure: rationale for inclusion orexclusion (continued) Proposedmeasures Importance Scienti?cacceptability Usability Feasibility Recommended forfurther consideration or development Hospital-based emergencies Venous thromboembolism risk assessment Yes Venous thromboembolism is a leading cause of death in the UnitedStatesandhassigni?cant long-term sequela. Yes Multiple protocols, evidence addresses primary prevention for patients at increased risk; pregnancy is risk factor, yet no clinical (...) trials: re: prevention in pregnancy. Unclear International population- based cohort studies demonstrate improved maternal outcomes (decreased mortality rate). Yes Current infrastructure for risk assessment and monitoring has been implemented widely in hospitals for nonpregnant medical and surgical populations. Yes All pregnant women should undergo venous thromboembolism risk assessment and receive treatment if at increased risk; recommend tracking of prophylaxis rates, harms (wound infection, heparin

2017 Society for Maternal-Fetal Medicine

52. Cohort study: Pregnant women with schizophrenia are at higher risk of pre-eclampsia, venous thromboembolism and adverse neonatal outcomes

in schizophrenic mothers confirm previous findings in the context of newer antipsychotic drugs and treatment practices. Women with schizophrenia should be counselled about increased risks and followed by a provider specialising in high-risk pregnancies. Strategies to address modifiable risk factors during pregnancy and the perinatal period are necessary. Special attention should be given to smoking cessation and control of blood pressure. Novel findings include increased rates of thromboembolic disease (...) Cohort study: Pregnant women with schizophrenia are at higher risk of pre-eclampsia, venous thromboembolism and adverse neonatal outcomes Pregnant women with schizophrenia are at higher risk of pre-eclampsia, venous thromboembolism and adverse neonatal outcomes | Evidence-Based Nursing We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our

2015 Evidence-Based Nursing

53. Weight change across the start of three consecutive pregnancies and the risk of maternal morbidity and SGA birth at the second and third pregnancy. Full Text available with Trip Pro

/period). Women who were overweight/obese at first pregnancy had higher risk of substantial weight-gain and loss (>10kg) during each of two inter-pregnancy periods. Inter-pregnancy weight-gain (> 2BMI units) between first and second pregnancy increased the risk of maternal morbidity (1or more event of hypertensive disease, caesarean-section, thromboembolism) at second pregnancy, while weight-loss (>2BMI units) increased the risk of SGA-birth. Similarly, increased risk of maternal morbidity (...) Weight change across the start of three consecutive pregnancies and the risk of maternal morbidity and SGA birth at the second and third pregnancy. Weight-change across parities and/or current BMI may influence maternal and fetal morbidity and requires to be differentiated to better inform weight-management guidance.Direction, pattern and magnitude of weight-change across three consecutive parities and thereby two inter-pregnancy periods was described in 5079 women. The association between

2017 PLoS ONE

54. Comparative Effectiveness of Warfarin and Newer Oral Anticoagulants for the Long-term Prevention and Treatment of Arterial and Venous Thromboembolism

Thromboembolic diseases represent a major public health burden and are associated with significant morbidity and mortality. For over 50 years, vitamin K antagonists (VKAs) have been the mainstay of treatment and prophylaxis of thromboembolism. There are many indications for VKA, including primary prevention of systemic embolism in nonvalvular atrial fibrillation (AF) and mechanical prosthetic heart valves. Other indications include secondary prophylaxis following venous thromboembolism (VTE) and preventing (...) of Veterans Affairs Veterans Health Administration vitamin K antagonist venous thromboembolism 8 Warfarin and Newer Oral Anticoagulants: Long-term Prevention and Treatment of Arterial and VTE Evidence-based Synthesis Program EVIDENCE REPORT INTRODUCTION Thromboembolic diseases represent a major public health burden and are associated with significant morbidity and mortality. For more than 50 years, vitamin K antagonists (VKAs) have been the mainstay of treatment and prophylaxis of thromboembolism

2012 Veterans Affairs Evidence-based Synthesis Program Reports

55. PROphylaxis for Venous ThromboEmbolism in Severe Traumatic Brain Injury (PROTEST)

-regulated Drug Product: No Studies a U.S. FDA-regulated Device Product: No Product Manufactured in and Exported from the U.S.: No Keywords provided by Sunnybrook Health Sciences Centre: Sequential Compression Device Anticoagulant Thromboprophylaxis Deep Vein Thrombosis Sub Cutaneous VTE Additional relevant MeSH terms: Layout table for MeSH terms Wounds and Injuries Brain Injuries Brain Injuries, Traumatic Thromboembolism Venous Thromboembolism Brain Diseases Central Nervous System Diseases Nervous (...) PROphylaxis for Venous ThromboEmbolism in Severe Traumatic Brain Injury (PROTEST) PROphylaxis for Venous ThromboEmbolism in Severe Traumatic Brain Injury (PROTEST) - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding

2018 Clinical Trials

56. Validation of the 4TS RAM in the Prevention of Venous Thromboembolism in Patients With Plasma Cell Dyscrasias.

of the study is to investigate clinical and disease related risk factors for venous thromboembolism (VTE) in these patients as well as possible biomarkers of hypercoagulability linked with the occurrence of venous thromboembolism at diagnosis and during the disease course. The purpose is to create a risk assessment model for VTE in newly diagnosed multiple myeloma patients and make the model more accurate by combining relevant clinical and disease characteristics with biomarkers of cellular and plasma (...) heparin (tinzaparin). In addition to symptomatic patients with multiple myeloma the study aims to investigate VTE risk in all plasma cell dyscrasias and will recruit patients with monoclonal gammopathy of undetermined significance, asymptomatic multiple myeloma, primary amyloidosis and Waldenström's macroglobulinemia. Condition or disease Intervention/treatment Multiple Myeloma Venous Thromboembolism Other: No intervention Study Design Go to Layout table for study information Study Type

2018 Clinical Trials

57. Galectin-3 for Thromboembolic Formation in Patients With Atrial Fibrillation CHAâ‚‚DSâ‚‚-VASc Scoring

years. Diagnosed as non valvular atrial fibrillation patients either paroxysmal or persistent types. Exclusion Criteria: pregnancy valvular heart diseases. Congenital heart diseases. Heart failure. Ischemic heart disease. Inflammatory diseases. Cancer. Thyroid disease. Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer (...) Galectin-3 for Thromboembolic Formation in Patients With Atrial Fibrillation CHAâ‚‚DSâ‚‚-VASc Scoring Galectin-3 for Thromboembolic Formation in Patients With Atrial Fibrillation CHA₂DS₂-VASc Scoring - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please

2018 Clinical Trials

58. High Burden of 30‐Day Readmissions After Acute Venous Thromboembolism in the United States Full Text available with Trip Pro

High Burden of 30‐Day Readmissions After Acute Venous Thromboembolism in the United States Venous thromboembolism (VTE) is the third leading cause of vascular disease and accounts for $10 billion in annual US healthcare costs. The nationwide burden of 30-day readmissions after such events has not been comprehensively assessed.We analyzed adults ≥18 years of age with hospitalizations associated with acute VTE between January 1, 2010, and December 31, 2014, in the Nationwide Readmissions (...) Database. International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes were used to identify hospitalizations associated with acute pulmonary embolism or deep vein thrombosis. The primary outcome was the rate of unplanned 30-day readmission. Hierarchical logistic regression was used to calculate hospital-specific 30-day risk-standardized readmission rates, a marker of healthcare quality. Among 1 176 335 hospitalizations with acute VTE, in-hospital death occurred

2018 Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

59. Thromboembolic Disease in Pregnancy

Thromboembolic Disease in Pregnancy Thromboembolic Disease in Pregnancy 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 Thromboembolic (...) Disease in Pregnancy Thromboembolic Disease in Pregnancy Aka: Thromboembolic Disease in Pregnancy , Deep Vein Thrombosis in Pregnancy , Deep Venous Thrombosis During Pregnancy , DVT in Pregnancy , DVT Prophylaxis in Pregnancy II. Epidemiology Venous Thrombosis risk: 0.5 to 3 per 1000 pregnancies risk is increased 5 fold in pregnancy DVT occurs equally in all trimesters (but increases with each trimester and especially postpartum) III. Pathophysiology Hypercoagulation in pregnancy Procoagulants

2015 FP Notebook

60. The Management of Nausea and Vomiting of Pregnancy and Hyperemesis Gravidarum

. 10,11 They are primarily thought to be associated with rising levels of beta human chorionic gonadotrophin (hCG) hormone, and conditions with higher hCG levels, such as trophoblastic disease and multiple pregnancy, have been associated with increased severity of NVP . 12,13 3. Identification and assessment of evidence This guideline was developed in accordance with standard methodology for producing Royal College of Obstetricians and Gynaecologists (RCOG) Green-top Guidelines. Databases searched (...) : – hypokalaemia/hyperkalaemia – hyponatraemia – dehydration – renal disease Full blood count: – infection – anaemia – haematocrit Blood glucose monitoring: – exclude diabetic ketoacidosis if diabetic Ultrasound scan: – confirm viable intrauterine pregnancy – exclude multiple pregnancy and trophoblastic disease In refractory cases or history of previous admissions, check: – TFTs: hypothyroid/hyperthyroid – LFTs: exclude other liver disease such as hepatitis or gallstones, monitor malnutrition – calcium

2016 Royal College of Obstetricians and Gynaecologists

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