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Thromboembolic Disease in Pregnancy

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101. 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

102. 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 (...) with (as opposed to starting on day 1-2 as with older protocols) Delay in past has been due to initial prothrombotic effect of However appears to counter this effect even early in course and s are contraindicated in pregnancy, severe liver disease, breakthrough VTE, some cancers See Continue in these cases Initial Dosing See for further dosing information Age <65 years: Start 10 mg daily Dose of 10 mg start was therapeutic 1.4 days earlier Age >65 years: Start 5 mg daily Age >75 years: Start 2.5 mg daily Check

2018 FP Notebook

103. Hokusai Study in Pediatric Patients With Confirmed Venous Thromboembolism (VTE)

in pediatric subjects with confirmed VTE. Condition or disease Intervention/treatment Phase Venous Thromboembolism (VTE) Pulmonary Embolism Deep Vein Thrombosis (DVT) Drug: Edoxaban Drug: Standard of Care Phase 3 Detailed Description: The objective is to demonstrate the non-inferiority of edoxaban to standard of care (SOC; including low molecular weight heparin (LMWH), vitamin K antagonist (VKA), or synthetic pentasaccharide (SP) Xa inhibitors) in the treatment and secondary prevention of VTE in pediatric (...) relevant MeSH terms: Layout table for MeSH terms Thrombosis Thromboembolism Embolism Venous Thromboembolism Pulmonary Embolism Venous Thrombosis Embolism and Thrombosis Vascular Diseases Cardiovascular Diseases Lung Diseases Respiratory Tract Diseases Heparin Edoxaban Fondaparinux Anticoagulants Fibrinolytic Agents Fibrin Modulating Agents Molecular Mechanisms of Pharmacological Action Factor Xa Inhibitors Antithrombins Serine Proteinase Inhibitors Protease Inhibitors Enzyme Inhibitors

2016 Clinical Trials

104. Inflammation as a cause of venous thromboembolism. (PubMed)

inflammation-related conditions including aging, autoimmune disease, cancer, cardiovascular diseases, hormone replacement therapy, infectious diseases, metabolic diseases, overweight or obesity, pregnancy or postpartum, respiratory diseases, and trauma have been associated with an increased risk of VTE. At this moment, despite their theoretical potential, to achieve the implementation of the inflammation-related laboratory tests in practice is a long task and future studies with larger sample sizes (...) Inflammation as a cause of venous thromboembolism. Inflammatory markers are highly amenable to appraise and adjust and could already serve as a diagnostic indicator and also as a predictor of prognosis over the management of many health problems. Inflammation is implicated in venous thromboembolism (VTE). However there is still an intense curiosity about whether it is a cause or only a consequence of the thromboembolic process. The more likely scenario is that some inflammatory mediators

2016 Critical reviews in oncology/hematology

105. The epidemiology of venous thromboembolism (PubMed)

The epidemiology of venous thromboembolism Venous thromboembolism (VTE) is categorized by the U.S. Surgeon General as a major public health problem. VTE is relatively common and associated with reduced survival and substantial health-care costs, and recurs frequently. VTE is a complex (multifactorial) disease, involving interactions between acquired or inherited predispositions to thrombosis and VTE risk factors, including increasing patient age and obesity, hospitalization for surgery or acute (...) illness, nursing-home confinement, active cancer, trauma or fracture, immobility or leg paresis, superficial vein thrombosis, and, in women, pregnancy and puerperium, oral contraception, and hormone therapy. Although independent VTE risk factors and predictors of VTE recurrence have been identified, and effective primary and secondary prophylaxis is available, the occurrence of VTE seems to be relatively constant, or even increasing.

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2016 Journal of thrombosis and thrombolysis

106. Pregnancy outcome in patients with sickle cell disease in the UK--a national cohort study comparing sickle cell anaemia (HbSS) with HbSC disease. (PubMed)

Pregnancy outcome in patients with sickle cell disease in the UK--a national cohort study comparing sickle cell anaemia (HbSS) with HbSC disease. We describe the findings from a national study of maternal and fetal outcomes of pregnancy in women with sickle cell disease (SCD). Data were collected via the United Kingdom Obstetric Surveillance System between 1 February 2010 and 31 January 2011 from 109 women, of whom 51 (46·8%) had HbSS and 44 (40·4%) had HbSC. Data included antenatal, maternal (...) and fetal outcomes. Comparisons were made between women with HbSS and HbSC. Incidence of complications were acute pain (57%), blood transfusion (26%), urinary tract infection (UTI; 12%) and critical care unit admission (23%) and these were all more common in women with HbSS than HbSC. There was no difference in the incidence of acute chest syndrome, hypertension and venous thromboembolism between HbSS and HbSC. Women with HbSS were more likely to deliver at <37 weeks gestation (P = 0·01

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2015 British journal of haematology

107. Trends in Venous Thromboembolism among Pregnancy-Related Hospitalizations, United States, 1994-2009. (PubMed)

Trends in Venous Thromboembolism among Pregnancy-Related Hospitalizations, United States, 1994-2009. The purpose of this study was to evaluate national trends in the rate of pregnancy-related hospitalizations for venous thromboembolism (VTE) from 1994-2009 and to estimate the prevalence of comorbid conditions among these hospitalizations.An estimated 64,413,973 pregnancy-related hospitalizations among women 15-44 years old were identified in the 1994-2009 Nationwide Inpatient Sample. Trends (...) , there was a 14% increase in the rate of overall VTE-associated pregnancy hospitalizations; antepartum and postpartum hospitalizations with VTE increased by 17% and 47%, respectively. Between 1994-1997 and 2006-2009, the prevalence of hypertension and obesity doubled among all VTE-associated pregnancy hospitalizations; significant increases in diabetes mellitus and heart disease were also noted. A temporal increase in the likelihood of a VTE diagnosis in pregnancy was observed for antepartum hospitalizations

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2013 American Journal of Obstetrics and Gynecology

108. Risk factors for first venous thromboembolism around pregnancy: a population-based cohort study from the United Kingdom. (PubMed)

Risk factors for first venous thromboembolism around pregnancy: a population-based cohort study from the United Kingdom. Knowledge of the absolute risk (AR) for venous thromboembolism (VTE) in women around pregnancy and how potential risk factors modify this risk is crucial in identifying women who would benefit most from thromboprophylaxis. We examined a large primary care database containing 376 154 pregnancies ending in live birth or stillbirth from women aged 15 to 44 years between 1995 (...) and 2009 and assessed the effect of risk factors on the incidence of antepartum and postpartum VTE in terms of ARs and incidence rate ratios (IRR), using Poisson regression. During antepartum, varicose veins, inflammatory bowel disease (IBD), urinary tract infection, and preexisting diabetes were associated with an increased risk for VTE (ARs, ≥139/100 000 person-years; IRRs, ≥1.8/100 000 person-years). Postpartum, the strongest risk factor was stillbirth (AR, 2444/100 000 person-years; IRR, 6.2/100

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2013 Blood

109. Comparison of Low and Intermediate Dose Low-molecular-weight Heparin to Prevent Recurrent Venous Thromboembolism in Pregnancy

. Middeldorp, Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA): Low-molecular-weight heparin Pregnancy Venous thrombosis Additional relevant MeSH terms: Layout table for MeSH terms Thrombosis Embolism Venous Thromboembolism Pulmonary Embolism Venous Thrombosis Embolism and Thrombosis Vascular Diseases Cardiovascular Diseases Thromboembolism Lung Diseases Respiratory Tract Diseases Heparin Calcium heparin Heparin, Low-Molecular-Weight Dalteparin Tinzaparin Nadroparin Enoxaparin (...) Comparison of Low and Intermediate Dose Low-molecular-weight Heparin to Prevent Recurrent Venous Thromboembolism in Pregnancy Comparison of Low and Intermediate Dose Low-molecular-weight Heparin to Prevent Recurrent Venous Thromboembolism in Pregnancy - 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

2013 Clinical Trials

110. Management of AML in Pregnancy

pregnancy should be managed jointly by consultant haematologists, obstetricians, anaesthetists and neonatologists. Consideration should be given to the health of both mother and baby and the informed wishes of the mother. The woman should be fully informed about the diagnosis, treatment of the disease and possible complications during pregnancy. Treatment delays may compromise maternal outcome without improving the outcome for the foetus (Greenlund et al , ). Without treatment, maternal death can occur (...) . & Chapman, S.W. ( 1998 ) Antifungal therapy during pregnancy . Clinical Infectious Diseases , 27 , 1151 – 1160 . Lynch, C.M. , Sinnott, J.T. , Holt, D.A. & Herold, A.H. ( 1991 ) Use of antibiotics during pregnancy . American Family Physician , 43 , 1365 – 1368 . Meyer‐Wittkopf, M. , Barth, H. , Emons, G. & Schmidt, S. ( 2001 ) Fetal cardiac effects of doxorubicin therapy for carcinoma of the breast during pregnancy: case report and review of the literature . Ultrasound in Obstetrics & Gynecology , 18

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2015 British Committee for Standards in Haematology

111. Obesity in pregnancy

(Gestational diabetes mellitus and Diabetes in Pregnancy ) 14 • Preeclampsia 14 • Obstructive sleep apnoea—may be related to adverse fetal outcomes 14 • Thromboembolic disease 14 • Cholecystitis 14 • Depression 4 • Difficulties with abdominal palpitation and obtaining adequate auscultation of fetal heart and cardiotocograph (CTG) • Suboptimal ultrasonography 5 • Diagnosis of congenital abnormality 17 • Preterm birth (PTB)—mostly associated with comorbidities 14,18 • Increased odds of dizygous twinning 19 (...) • Haemorrhage 14 • Chest, genital tract, wound and urinary infections 14 • Reduced rate of breastfeeding 14 • Postnatal depression 27 • Thromboembolic disease Neonatal/ childhood • Admission to neonatal intensive care units 14 • Macrosomia 14 • Congenital malformations 17 • Obesity 14 and metabolic syndrome 28 • Neurodevelopmental disorders (e.g. autism, developmental delays) 29 • Asthma 30 Queensland Clinical Guideline: Obesity in pregnancy Refer to online version, destroy printed copies after use Page 10

2015 Queensland Health

112. SMFM State of Pregnancy Monograph

physicians and scientists is dedicated to the optimization of pregnancy and perinatal outcomes. SMFM’s mission is to improve maternal and child outcomes, raising the standards of prevention, diagnosis, and treatment of maternal and fetal disease through: support for the clinical practice of maternal-fetal medicine; research; education/training; advocacy; health policy leadership. Since 1980 the Society has annually hosted educational meetings at which peer-reviewed research and postgraduate courses (...) (GR) Committee and engage more actively newer members of the Society who are interested in GR. As part of this, SMFM has developed an Advocacy Guidebook for members so that anyone can learn more about advocacy and how to be an effective advocate. SMFM is also the leading voice in an effort to improve information on drugs that women may need during pregnancy and lactation. With more women of advanced maternal age getting pregnant and the increasing rates of chronic disease in the general population

2015 Society for Maternal-Fetal Medicine

113. Heart Disease and Stroke Statistics

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 (...) disease. Admissions for endocarditis related to injection drug use have risen in recent years in parallel with the opioid drug crisis. The prevalence of documented intravenous drug use among people admitted to a hospital because of endocarditis in the National (Nationwide) Inpatient Sample rose from 4.3% in 2008 to 10% in 2014. Venous Thromboembolism (Deep Vein Thrombosis and Pulmonary Embolism), Chronic Venous Insufficiency, Pulmonary Hypertension (Chapter 22) Traditional atherosclerotic risk factors

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2019 American Heart Association

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

Canadian Association of Gastroenterology Clinical Practice Guideline for the Management of Luminal Crohn’s Disease e1 © The Author(s) 2019. This article is being published jointly in the Journal of the Canadian Association of Gastroenterology and Clinical Gastroenterology and Hepatology by the Canadian Association of Gastroenterology and the AGA Institute This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http (...) ://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. Original Article CLINICAL PRACTICE GUIDELINES Canadian Association of Gastroenterology Clinical Practice Guideline for the Management of Luminal Crohn’s Disease Remo Panaccione* ,a , A. Hillary Steinhart ‡,a , Brian Bressler § , Reena Khanna ? , John K. Marshall ¶ , Laura T argownik # , Waqqas Afif**, Alain Bitton**, Mark Borgaonkar ‡‡ , Usha

2019 Canadian Association of Gastroenterology

115. BSG consensus guidelines on the management of inflammatory bowel disease in adults

BSG consensus guidelines on the management of inflammatory bowel disease in adults 1 Version accepted by Gut 10 th June 2019 British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults Authors Christopher A. Lamb 1,2 *, Nicholas A. Kennedy 3,4 , Tim Raine 5 , Philip Hendy 6,7 , Philip J. Smith 8 , Jimmy K. Limdi 9,10 , Bu’Hussain Hayee 11,12 , Miranda Lomer 12,13 , Gareth C. Parkes 14,15 , Christian P. Selinger 16,17 , Kevin J. Barrett 18 (...) Trust, Wolverhampton, WV10 0QP, UK 39. University of Wolverhampton, Wolverhampton, WV1 1LY, UK 40. University Hospital of Wales, Cardiff, CF14 4XW, UK See Supplementary Table 1 for affiliations of the IBD guidelines eDelphi consensus group Accepted manuscript 4 Version accepted by Gut 10 th June 2019 Keywords Ulcerative colitis, UC, colitis, Crohn’s disease, CD, ileitis, granuloma, fistula, stricture, perianal, inflammatory bowel disease, IBD, pouch, pouchitis, guideline, classification, diagnosis

2019 British Society of Gastroenterology

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

Canadian Association of Gastroenterology Clinical Practice Guideline for the Medical Management of Pediatric Luminal Crohn’s Disease e35 © The Author(s) 2019. This article is being published jointly in the Journal of the Canadian Association of Gastroenterology and Clinical Gastroenterology and Hepatology by the Canadian Association of Gastroenterology and the AGA Institute This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (...) (http:// creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. Original article Canadian Association of Gastroenterology Clinical Practice Guideline for the Medical Management of Pediatric Luminal Crohn’s Disease David R. Mack 1,2,3 , Eric I. Benchimol 1,2,3,4 , Jeff Critch 3,5 , Jennifer deBruyn 3,6 , Frances T se 7 , Paul Moayyedi 7 , Peter Church 3,8 , Colette Deslandres 3,9 , Wael

2019 Canadian Association of Gastroenterology

117. Prevention and management of venous thromboembolism

thromboembolism 4 2.2 Thromboprophylaxis in surgical patients 4 2.3 Thromboprophylaxis in medical patients 4 2.4 Pregnancy and the puerperium 4 2.5 Diagnosis of venous thromboembolism 5 2.6 Preliminary assessment 5 2.7 Initial management of venous thromboembolism 5 2.8 Further management of venous thromboembolism 5 2.9 Adverse effects of venous thromboembolism prophylaxis and treatment 6 3 a ssessment of risk for venous thromboembolism 7 3.1 Introduction 7 3.2 Clinical assessment of venous thrombosis risk 7 (...) Cerebral vein thrombosis 47 11.6 Splanchnic vein thrombosis 47 r evised n ov. 2011 Prevention and management of venous thromboembolism11.7 Incidental VTE 48 11.8 Pregnancy 48 12 f urther management of venous thromboembolism 49 12.1 Choice of anticoagulant 49 12.2 Graduated elastic compression stockings 51 13 monitoring the anticoagulant effect 52 13.1 Unfractionated heparin 52 13.2 Low molecular weight heparin 52 13.3 Warfarin 52 14 o utpatient management of acute vte 54 14.1 Deep vein thrombosis 54

2010 SIGN

118. Air Travel and Pregnancy

–security–scanner]. Scientific Impact Paper 1 © Royal College of Obstetricians and Gynaecologists 5of 67. Centers for Disease Control and Prevention. Travelling While Pregnant. [http://wwwnc.cdc.gov/ travel/yellowbook/2012/chapter–8–advising–travelers–with–specific–needs/pregnant–travelers.htm]. 8. Hezelgrave NL, Whitty CJ, Shennan AH, Chappell LC. Advising on travel during pregnancy. BMJ 2011;342:d2506. 9. Civil Aviation Authority. Guidance for Health Professionals Information on assessing fitness (...) Air Travel and Pregnancy Air Travel and Pregnancy Scientific Impact Paper No. 1 May 2013Air Travel and Pregnancy This is the third edition of this paper, which was published in 2001 and 2005 under the title ‘Advice on Preventing Deep Vein Thrombosis (DVT) for Pregnant Women Travelling by Air’. 1. Background Obstetricians are commonly asked to give advice on whether it is suitable for women who are pregnant to fly during pregnancy. Such advice is sought because of the physiological

2013 Royal College of Obstetricians and Gynaecologists

119. Clinical practice guideline for care in pregnancy and puerperium

disease requiring medication • Liver disease with failure • Thromboembolic disease • Neoplastic disease • HIV infection or hepatitis B virus infection • Cystic Fibrosis • Other serious medical and surgical conditions • Family history of genetic diseases • Physical or mental disability38 CLINICAL PRACTICE GUIDELINES IN THE SNS Obstetrical pathology during pregnancy and the puerperium: • Pregnancy-induced hypertension • Severe anaemia • Gestational Diabetes • Recurrent urinary tract infection (...) creatinine level in a biochemical test? 8. What is the purpose of determining the plasma uric acid level in a biochemical test? 9. What is the purpose of universal screening for syphilis in pregnant women and at what stage of pregnancy should it be done? 10. What is the purpose of universal screening for Chagas disease in pregnant women and at what stage of pregnancy should it be done? 11. What is the purpose of universal screening for chlamydia in pregnant women and at what stage of pregnancy should

2014 GuiaSalud

120. A single-center experience with 12 consecutive cases of pregnancy among patients with membranous ventricular septal aneurysm. (PubMed)

A single-center experience with 12 consecutive cases of pregnancy among patients with membranous ventricular septal aneurysm. Membranous ventricular septal aneurysm (MVSA) is a rare cardiac anomaly that can occur as an isolated entity or being associated with other cardiac malformations. Complications of MVSA include thromboembolism, arrhythmia, rupture, bacterial endocarditis, right ventricular outflow tract obstruction, and atrioventricular valve diseases.The success rate of pregnancy (...) delivery. One patient terminated pregnancy in the second trimester- necessitated by cardiogenic shock. The other mothers had varying degrees of cardiac morbidity, but survived. Ten of thirteen newborns survived. Congenital heart disease and small-for-gestational-age (SGA) of newborn occurred in two cases (one twin and one single gestation). Two of these babies expired.Maternal and neonatal risk appeared associated with heart functional classifications, pulmonary hypertension and histories of cardiac

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2018 BMC Pregnancy and Childbirth

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