Skip to main content
SpringerLink
Log in

Venöse Thromboembolien, Thrombophilie und Thromboseprophylaxe in Gynäkologie und Geburtshilfe

Teil I: Häufigkeit, Pathophysiologie, klinische Risikokonstellationen und Prinzipien zur Prophylaxe venöser Thromboembolien

  • Chapter
Weiterbildung Gynäkologie und Geburtshilfe

  • 1890 Accesses

Zussamenfassung

Venöse Thromboembolien (VTE) gehen mit hoher Morbidität und Mortalität einher. Die demographische Entwicklung und die Zunahme ausgedehnter Eingriffe tragen dazu bei, das Risiko für thromboembolische Komplikationen zu erhöhen. Die Identifikation genetisch bedingter thrombophiler Varianten und die Beurteilung erworbener Gefährdungspotenziale erlauben es heute, das individuelle VTE-Risikoprofil einzuschätzen und eine risikoadaptierte VTE-Prophylaxe vorzunehmen. Auf der Grundlage aktualisierter Leitlinien werden in Teil I dieser Beitragsserie Prinzipien und Strategien zur Thromboembolieprophylaxe dargestellt und dazu allgemeine und physikalische Maßnahmen erörtert.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 34.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 44.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Heit JA (2008) The epidemiology of venous thromboembolism in the community. Arteriosder Thromb Vasc Biol 28(3):370–372

    Article  CAS  Google Scholar 

  2. Roger VL, Go AS, Lloyd-Jones DM et al (2012) Executive summary: heart disease and stroke statistics - 2012 update: a report from the American Heart Association. Circulation 125(1):188–197

    Article  PubMed  Google Scholar 

  3. Raskob GE, Silverstein R, Bratzier DW et al (2010) Surveillance for deep vein thrombosis and pulmonary embolism: recommendations from a national workshop. Am J Prev Med 38(4 Suppl):S502–S509

    Article  PubMed  Google Scholar 

  4. Cohen AT, Agnelli G, Anderson FA et al (2007) Venous thromboembolism (VTE) in Europe. The number of VTE events and associated morbidity and mortality. Thromb Haemost 98(4):756–764

    Google Scholar 

  5. Silverstein MD, Heit JA, Mohr DN et al (1998) Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study. Arch Intern Med 158(6)585–593

    Google Scholar 

  6. Fuchs TA, Brill A, Wagner DD (2012) Neutrophil extracellular trap (NET) impact on deep vein thrombosis. Arteriosder Thromb Vasc Biol 32(8):1777–1783

    Article  CAS  Google Scholar 

  7. Egeberg O (1965) Inherited antithrombin deficiency causing thrombophilia. Thromb Diath Haemorrh 13:516–530

    CAS  PubMed  Google Scholar 

  8. Griffin JH, Evatt B, Zimmerman TS et al (1981) Deficiency of protein C in congenital thrombotic disease. J Clin Invest 68(5):1370–1373

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Mannhalter C (2008) Molecular biology and haemostasis. Haemostaseologie 28(5):272–288

    Google Scholar 

  10. Scharf RE (2011) Hemostatic disorders: clinical management based on molecular mechanisms. Fortschr Neurol Psychiatr 79(3):171-185 (quiz 186-178)

    Google Scholar 

  11. Dahlback B, Carlsson M, Svensson PJ (1993) Familial thrombophilia due to a previously unrecognized mechanism characterized by poor anticoagulant response to activated protein C: prediction of a cofactor to activated protein C. Proc Natl Acad Sci USA 90(3):1004–1008

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Bertina RM, Koeleman BP, Koster T et al (1994) Mutation in blood coagulation factor V associated with resistance to activated protein C. Nature 369(6475):64–67

    Article  CAS  PubMed  Google Scholar 

  13. Rosendaal FR, Reitsma PH (2009) Genetics of venous thrombosis. J Thromb Haemost 7(Suppl 1):301–304

    Google Scholar 

  14. Poort SR, Rosendaal FR, Reitsma PH, Bertina RM (1996) A common genetic variation in the 3'-untransla- ted region of the prothrombin gene is associated with elevated plasma prothrombin levels and an increase in venous thrombosis. Blood 88(10)3698–3703

    Google Scholar 

  15. Bosler D, Mattson J, Crisan D (2006) Phenotypic Heterogeneity in Patients with Homozygous Prothrombin 20210AA Genotype. A paper from the 2005 William Beaumont Hospital Symposium on Molecular Pathology. J Mol Diagn 8(4):420–425

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Sartori MT, Wiman B, Vettore S et al (1998) 4G/5G polymorphism of PAI-1 gene promoter and fibrinolytic capacity in patients with deep vein thrombosis. Thromb Haemost 80(6):956–960

    CAS  PubMed  Google Scholar 

  17. Francis CW (2002) Plasminogen activator inhibitor-1 levels and polymorphisms. Arch Pathol Lab Med 126(11):1401–1404

    CAS  PubMed  Google Scholar 

  18. KrivakTC ZKK (2007) Venous thromboembolism in obstetrics and gynecology. Obstet Gynecol 109(3):761–777

    Article  Google Scholar 

  19. Greer IA (1999) Thrombosis in pregnancy: maternal and fetal issues. The Lancet 353(9160):1258–1265

    Article  CAS  Google Scholar 

  20. Greer IA (2000) The challenge of thrombophilia in maternal-fetal medicine. N Engl J Med 342(6):424–425

    Article  CAS  PubMed  Google Scholar 

  21. Gerhardt A, Scharf RE, Beckmann MW et al (2000) Prothrombin and factor V mutations in women with a history of thrombosis during pregnancy and the puerperium. N Engl J Med 342(6)374–380

    Google Scholar 

  22. Zotz RB, Gerhardt A, Scharf RE (2003) A rebuttal: inherited thrombophilia and first venous thromboembolism during pregnancy and puerperium. Thromb Haemost 89(4):769–770

    CAS  PubMed  Google Scholar 

  23. Bonnar J (1999) Can more be done in obstetric and gynecologic practice to reduce morbidity and mortality associated with venous thromboembolism? Am J Obstet Gynecol 180(4):784–791

    Article  CAS  PubMed  Google Scholar 

  24. Clarke-Pearson DL, Abaid LN (2012) Prevention of venous thromboembolic events after gynecologic surgery. Obstet Gynecol 119(1):155–167

    Google Scholar 

  25. Blom JW, Vanderschoot JP, Oostindier MJ et al (2006) Incidence of venous thrombosis in a large cohort of 66,329 cancer patients: results of a record linkage study. J Thromb Haemost 4(3)529–535

    Google Scholar 

  26. Scharf RE (2011) Cancer, thromboembolia and antithrombotic therapy: is there an anticoagulant of choice? Dtsch Med Wochenschr 136(47):240–3

    Google Scholar 

  27. Heit JA, O'Fallon WM, Petterson TM et al (2002) Relative impact of risk factors for deep vein thrombosis and pulmonary embolism: a population-based study. Arch Intern Med 162(11):1245–1248

    Article  PubMed  Google Scholar 

  28. Statement NIHCDCC (1986) Prevention of venous thrombosis and pulmonary embolism. JAMA 256:74474–9

    Google Scholar 

  29. Bates SM, Greer IA, Pabinger I et al (2008) Venous thromboembolism, thrombophilia, antithrombotic therapy, and pregnancy: American College of Chest Physicians Evidence- Based Clinical Practice Guidelines, 8th edn. Chest 133(6 Suppl):844S- 886S

    Google Scholar 

  30. Bates SM, Greer IA, Middeldorp S et al (2012) VTE, thrombophilia, antithrombotic therapy, and pregnancy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 141(2 Suppl):e69–1S-e736S

    Google Scholar 

  31. Deutsche Gesellschaft für Gynäkologie und Geburtshilfe eV (2009) S-3 Leitlinie zur Prophylaxe der venösen Thromboembolie, http://www.dggg.de/Leitlinien/1-7-1-thromboembo-lie-2009-kurzfassung.pdf

  32. Geerts WH, Bergqvist D, Pineo GF et al (2008) Prevention of venous thromboembolism: American College of Chest Physicians Evidence- Based Clinical Practice Guidelines (8th edn). Chest 133(6 Suppl):381 S-453S

    Google Scholar 

  33. Nicolaides A, Goldhaber SZ, Maxwell GL et al (2008) Cost benefit of intermittent pneumatic compression for venous thromboembolism prophylaxis in general surgery. Int Angiol 27(6)500–506

    Google Scholar 

  34. National Institute for Health and Clinical Excellence (2007) Venous thromboembolism. Reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in inpatients undogoing surgery. Clinical giudeline No 46. http://www.nice.org.uk/guidan-ce/index

  35. Phillips SM, Gallagher M, Buchan H (2008) Use graduated compression stockings postoperativelyto prevent deep vein thrombosis. BMJ 336(7650):943–944

    Article  PubMed  PubMed Central  Google Scholar 

  36. Gould MK, Garcia DA, Wren SM et al (2012) Prevention of VTE in nonorthopedic surgical patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 141(2 Suppl):e22–7S-e277S

    Article  Google Scholar 

  37. Gerhardt A, Scharf RE, Zotz RB (2009) Successful use of danaparoid in two pregnant women with heart valve prosthesis and heparin-induced thrombocytopenia Type II (HIT). Clin Appl Thromb Hemost 15(4):461 -464

    Google Scholar 

  38. Gerhardt A, Zotz RB, Stockschlaeder M, Scharf RE (2007) Fondaparinux is an effective alternative anticoagulant in pregnant women with high risk of venous thromboembolism and intolerance to low-molecular-weight heparins and heparinoids. Thromb Haemost 97(3):496–497

    CAS  PubMed  Google Scholar 

  39. Seidel HKH, Buchbinder S, Hoffmann T, Scharf RE (2014) Monitoring of argatroban and hirudin: what is the input of laboratory values in, real life'? (zurVeröffentlichung eingereicht)

    Google Scholar 

  40. Schinzel H (2007) Einsatz von niedermolekularen Heparinen bei Niereninsuffizienz. Vasc Care 12(1):18–31

    Google Scholar 

  41. Hull RD, Pineo GF, Stein PD et al (2001) Timing of initial administration of low-molecular-weight heparin prophylaxis against deep vein thrombosis in patients following elective hip arthroplasty: a systematic review. Arch Intern Med 161(16):1952–1960

    Article  CAS  PubMed  Google Scholar 

  42. Guyatt GH, Akl EA, Crowther M et al (2012) Executive summary: Anti- thrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence- Based Clinical Practice Guidelines. Chest 141 (2 Suppl):7S–47S

    Google Scholar 

  43. Rasmussen MS, Jorgensen LN, Wil- le-Jorgensen P (2009) Prolonged thromboprophylaxis with low molecular weight heparin for abdominal or pelvic surgery. Cochrane Database Syst Rev 1 :CD00431–8

    Google Scholar 

  44. Peedicayil A, Weaver A, Li X et al (2011) Incidence and timing of venous thromboembolism after surgery for gynecological cancer. Gynecol Oncol 121(1):64–69

    Article  PubMed  Google Scholar 

  45. Andtbacka RH, Babiera G, Singletary SE et al (2006) Incidence and prevention of venous thromboembolism in patients undergoing breast cancer surgery and treated according to clinical pathways. Ann Surg 243(1 ):96–101

    Google Scholar 

  46. Friis E, Horby J, Sorensen LT et al (2004) Thromboembolic prophylaxis as a risk factor for postoperative complications after breast cancer surgery. World J Surg 28(6)540–543

    Google Scholar 

  47. Kuderer NM, Khorana AA, Lyman GH, Francis CW (2007) A meta-analysis and systematic review of the efficacy and safety of anticoagulants as cancer treatment: impact on survival and bleeding complications. Cancer 110(5):1149–1161

    Article  CAS  PubMed  Google Scholar 

  48. Lyman GH, Khorana AA, Falanga A et al (2007) American Society of Clinical Oncology Guideline: recommendations for venous thromboembolism prophylaxis and treatment in patients with cancer. J Clin Oncol 25(34)5490–5505

    Google Scholar 

  49. Chan WS (2009) The, ART' of thrombosis: a review of arterial and venous thrombosis in assisted reproductive technology. Curr Opin Obstet Gynecol 21(3):207–218

    Article  PubMed  Google Scholar 

  50. Zotz RB, Gerhardt A, Scharf RE (2006) Pregnancy-associated venous thromboembolic disease: prediction, prevention, and therapy. Hämostaseologie 26(1 ):63–71

    Google Scholar 

  51. Zotz RB, Sucker C, Gerhardt A (2008) Thrombophilia in pregnancy: venous thromboembolism, fetal loss, preeclampsia, intrauterine growth restriction. Hämostaseologie 28(5):455–464

    CAS  PubMed  Google Scholar 

  52. Duley L, Henderson-Smart DJ, Meher S, King JF (2007) Antiplatelet agents for preventing pre-eclampsia and its complications. Cochrane Database Syst Rev 2:CD00465–9

    Google Scholar 

  53. Gogarten W, Aken H van, Büttner J et al (2007) Rückenmarksnahe Regionalanästhesien undThromboem- bolieprophylaxe/antithrombotische Medikation. 2. überarbeitete Empfehlung der Deutschen Gesellschaft für Anästhesiologie und Intensivmedizin. Anasth Intensivmed 485109- S124

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinik für Gynäkologie und Gynäkologische Onkologie & Klinikfür Geburtshilfe und Perinatologie, Universitäts-Frauenklinik, Universitätsklinikum Albert-Ludwigs-Universität Freiburg, Heidelberg

    M.A. Pestka

  2. Institut für Flämostaseologie, Hämotherapie und Transfusionsmedizin und Hemophilia Comprehensive Care Center, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität, Düsseldorf

    R.E. Scharf F.A.H.A.

Authors
  1. M.A. Pestka
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R.E. Scharf F.A.H.A.
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Klinikum Kassel, Frauenklinik, Kassel, Deutschland

    Thomas Dimpfl

  2. Universitätsklinik Ulm, Frauenklinik, Ulm, Deutschland

    Wolfgang Janni

  3. Landshut, Deutschland

    Rolf Kreienberg

  4. Klinik für Gynäkologie und Geburtshilfe, Universitätsklinik Kiel, Kiel, Deutschland

    Nicolai Maass

  5. Klinik für Frauenheilkunde und Geburtshilfe, Caritas-Krankenhaus St. Josef, Regensburg, Deutschland

    Olaf Ortmann

  6. Frauenklinik, Universitätsklinik Heidelberg, Heidelberg, Deutschland

    Thomas Strowitzki

  7. Klinik für Frauenheilkunde, Vivantes Klinikum Neuköln, Berlin, Deutschland

    Klaus Vetter

  8. Klinik für Geburtshilfe, Universitätsspital Zürich, USZ, Zürich, Schweiz

    Roland Zimmermann

  9. Pränatale Medizin, Endokrinologie und Osteologie, amedes experts Hamburg Facharzt-Zentrum für Kinderwunsch, Hamburg, Deutschland

    Barbara Sonntag

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Pestka, M., Scharf F.A.H.A., R. (2017). Venöse Thromboembolien, Thrombophilie und Thromboseprophylaxe in Gynäkologie und Geburtshilfe. In: Dimpfl, T., et al. Weiterbildung Gynäkologie und Geburtshilfe. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-49480-6_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-49480-6_1

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-49479-0

  • Online ISBN: 978-3-662-49480-6

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics

Search

Navigation