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Thromboembolic Disease in Pregnancy

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41. Influence of socioeconomic factors on pregnancy outcome in women with structural heart disease. (PubMed)

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

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2017 Heart

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. 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

44. CRACKCast E177 – Acute Complications of Pregnancy

encephalopathy may also result. Intrahepatic cholestasis of pregnancy typically presents with generalized pruritus and mild jaundice. Nausea and Vomiting in Pregnancy Hyperemesis gravidarum is defined as nausea and vomiting that cause starvation metabolism, weight loss, dehydration, and prolonged ketonemia and ketonuria. Initial management involves rehydration with IV fluids, antiemetics, and demonstration of ability to take oral hydration. Thromboembolism in Pregnancy Thromboembolic disease accounts (...) check out EM Cases Rapid Reviews Videos on Shownotes – Key Points You know a chapter is gargantuan when the summary points are two pages long….so here we go. We’ll cover the key, key concepts Ectopic pregnancy Bleeding in late pregnancy Hypertension in pregnancy AF Embolism Rh immunization Abd pain in pregnancy N/V in pregnancy VTE in pregnancy Vaginal and UTIs Thyroid disease Ectopic Pregnancy An ectopic pregnancy can masquerade as a threatened miscarriage in the early stages of pregnancy

2018 CandiEM

45. 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

46. 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

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

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

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

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

49. 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

50. Venous Thromboembolism (VTE)

) Prior history of venous thromboembolism Advanced age (>70) Presence of a central venous catheter Malignancies, most commonly of the lung, pancreas, colorectal, kidney, and prostate Surgery (especially orthopedic) Trauma Pregnancy Oral contraceptive containing estrogen Hormone replacement therapy with estrogen Obesity Immobilization • Hospitalization • Prolonged travel • Limb immobilization (casting) • Stroke with movement deficit • Spinal cord injury; quadriplegia/paraplegia Inherited thrombophilias (...) (most common) • Factor V Leiden mutation • Prothrombin gene mutation • Protein S deficiency • Protein C deficiency • Antithrombin deficiency Antiphospholipid antibody syndrome (APS) Congestive heart failure Myeloproliferative disorders • Polycythemia vera • Essential thrombocytosis Inflammatory bowel disease Nephrotic syndrome Hyperhomocysteinemia Paroxysmal nocturnal hemoglobinuria Sources: UpToDate 2013 Bauer, Lip (literature review through May2013) 3 UMHS Venous Thromboembolism Guideline Update

2014 University of Michigan Health System

51. 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

52. High Burden of 30‐Day Readmissions After Acute Venous Thromboembolism in the United States (PubMed)

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

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

53. 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

54. 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

55. Pregnancy and venous thromboembolism. (PubMed)

Pregnancy and venous thromboembolism. This review provides a concise and complete overview of diagnostic work-up and treatment of venous thromboembolism in pregnancy, with attention to recent research developments and recent applicable guidelines. This may be useful for all the players of the multidisciplinary interaction needed in this disease management, namely cardiologists and gynecological/obstetric teams.Venous thromboembolism is, in the developed world, a major cause of maternal (...) and watchful eyes, deciding on a case-to-case and actively contributing in reducing pregnancy-related morbidity.Although there is an ongoing debate on various aspects of this condition and there is a paucity of high-quality studies, this review attempts to simplify the complex aspects of joining safety and efficacy in diagnosing and treating a possible two-people life-threatening disease.

2014 Current Opinion in Obstetrics and Gynecology

56. 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

57. 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

58. Maternal and neonatal outcomes of pregnancies in women with Addison's disease: a population-based cohort study on 7.7 million births. (PubMed)

Maternal and neonatal outcomes of pregnancies in women with Addison's disease: a population-based cohort study on 7.7 million births. To assess if pregnancies among women with Addison's disease (AD) are at higher risk of adverse maternal and neonatal outcomes.Population-based retrospective cohort study.All births in the United States' Healthcare Cost and Utilization Project-Nationwide Inpatient Sample from 2003 to 2011.Baseline characteristics were compared between women with AD and those (...) without, and prevalence over time was measured. Logistic regression was used to estimate the effect of AD on maternal and neonatal outcomes by calculating the crude and adjusted odds ratios (OR) and corresponding 95% confidence intervals (95% CI).We calculated a prevalence of AD in pregnancy of 5.5/100 000, increasing from 5.6 to 9.6/100 000 (P = 0.0001) over the 9-year study period. Compared with women without AD, women with AD were more likely to deliver preterm (OR 1.50, 95% CI 1.16-1.95), deliver

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2016 BJOG

59. Flowchart: Management of hypertension in pregnancy

investigations and fetal assessment Birth Inpatient or outpatient care Worsening maternal or fetal condition? Is birth indicated? Yes No No Yes Risk factors for preeclampsia • Previous history of preeclampsia • Family history of preeclampsia • Inter-pregnancy interval > 10 years • Nulliparity • Pre-existing medical conditions o APLS o Pre-existing diabetes o Renal disease o Chronic hypertension o Chronic autoimmune disease • Age > 40 years • BMI > 35 kg/m 2 • Multiple pregnancy • Elevated BP at booking (...) Flowchart: Management of hypertension in pregnancy Queensland Health State of Queensland (Queensland Health) 2016 http://creativecommons.org/licenses/by-nc-nd/3.0/au/deed.en Queensland Clinical Guidelines, Guidelines@health.qld.gov.au Queensland Clinical Guidelines www.health.qld.gov.au/qcg Management of hypertension in pregnancy Queensland Clinical Guidelines: Hypertensive disorders in pregnancy. Flowchart version: F15.13-2-V7-R20 Hypertension sBP = 140 mmHg and/or dBP = 90 mmHg Maternal

2016 Queensland Health

60. Hypertensive disorders of pregnancy

stable then every 30 minutes • Respiratory rate and patellar reflexes hourly • Temperature 2nd hourly • Continuous CTG monitoring if > 24 weeks (interpret with caution if : greater than, 10 years • Nulliparity • Pre-existing medical conditions o APLS o Pre-existing diabetes o Renal disease o Chronic hypertension o Chronic autoimmune disease • Age > 40 years • BMI > 35 kg/m 2 • Multiple pregnancy • Elevated BP at booking • Gestational trophoblastic disease • Fetal triploidy Maternal investigations (...) USS Ultrasound scan VTE Venous thromboembolism Definition of terms Expectant management Refers to prolongation of the pregnancy beyond 48 hours with maternal and fetal monitoring. 1 Multidisciplinary team May include as relevant to the clinical circumstances obstetrician, midwives, obstetric physician, anaesthetist, neonatologist/paediatrician experienced in the care of women with hypertension in pregnancy. Obstetrician Local facilities may differentiate the roles and responsibilities assigned

2016 Queensland Health

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