Perinatal Problems of Thrombosis and Haemostasis

  • Birger Åstedt
Conference paper


Prevention and treatment of deep vein thrombosis during pregnancy presents special problems. The benefit of treatment for the original condition must be weighed against the subsequent risk of placental or fetal haemorrhage. Owing to the high risk of recurrence, prophylactic treatment is required throughout pregnancy, during delivery, and in the puerperium. At an early stage of pregnancy, the risk ot teratogenetic effects needs also to be taken into consideration.


Deep Vein Thrombosis Tranexamic Acid Acute Pulmonary Embolism Hemorrhagic Complication Fibrinolytic System 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Åstedt B, Robertson B, Haeger K (1974) Experience with standardized streptokinase therapy of deep venous thrombosis. Surg Gynecol Obstet 139: 387–388PubMedGoogle Scholar
  2. 2.
    Flessa HC, Kapstrom AB, Glueck HI, Will JJ (1965) Placental transport of heparin. Am J Obstet Gynecol 93: 570–573PubMedGoogle Scholar
  3. 3.
    Forestier F, Daffos F, Capella-Pavlovsky M (1984) Low molecular weight heparin (PK 10169) does not cross the placenta during the second trimester of pregnancy: study by direct fetal blood sampling under ultrasound. Thromb Res 34: 557PubMedCrossRefGoogle Scholar
  4. 4.
    Forestier F, Daffos F, Rainaut M, Toulemonde F (1987) Low molecular weight Heparin (CY 216) does not cross the placenta during the third trimester of pregnancy. Thromb Hemost 57: 234Google Scholar
  5. 5.
    Âstedt B, Isacson S, Nilsson IM, Pandolfi M (1970) Fibrinolytic activity of veins during pregnancy. Acta Obstet Gynecol Scand 48: 171–173CrossRefGoogle Scholar
  6. 6.
    Bonnar J, McNicol GP, Douglas AS (1970) Coagulation and fibrinolytic mechanisms during and after childbirth. Br Med J 2: 200–203PubMedCrossRefGoogle Scholar
  7. 7.
    Bloomfield DK (1970) Fetal deaths and malformations associated with the use of coumarin derivatives in pregnancy. Am J Obstet Gynecol 107: 883–888PubMedGoogle Scholar
  8. 8.
    Carson M, Reid M (1976) Warfarin and fetal abnormality. Lancet 1: 1127CrossRefGoogle Scholar
  9. 9.
    Hall GJ (1967) Warfarin and fetal abnormality. Lancet 1: 1127Google Scholar
  10. 10.
    Holtzgreve W, Carey JC, Hall BD (1976) Warfain-induced fetal abnormalities. Lancet 2: 914–915CrossRefGoogle Scholar
  11. 11.
    DiSaia PJ (1966) Pregnancy and delivery of a patient with a Starr-Edwards mitral valve prosthesis. Obstet Gynecol 28: 469–472Google Scholar
  12. 12.
    Kerber IJ, Warr OS, Richardson C (1968) Pregnancy in a patient with a prosthetic mitral valve. JAMA 203: 157–159CrossRefGoogle Scholar
  13. 13.
    Tejani N (1973) Anticoagulant therapy with cardiac valve prosthesis during pregnancy. Obstet Gynecol 42: 785–793PubMedGoogle Scholar
  14. 14.
    Becker MH, Genieser NB, Finegold M, Miranda D, Spackman T (1975) Chondrodysplasia punctata. Am J Dis Child 129: 356–359PubMedGoogle Scholar
  15. 15.
    Fourie DT, Hay IT (1975) Warfarin as a possible teratogen. S Afr Med J 49: 2081–2083PubMedGoogle Scholar
  16. 16.
    Pettifor JM, Benson R (1975) Congenital malformations associated with the administration of oral anticoagulants during pregnancy. J Pediatr 86: 459–462PubMedCrossRefGoogle Scholar
  17. 17.
    Shaul WL, Emery H, Hall GJ (1975) Chondrodysplasia punctata and maternal warfarin use during pregnancy. Am J Dis Child 129: 360–362PubMedGoogle Scholar
  18. 18.
    Sherman S, Hall BD (1976) Warfarin and fetal abnormality. Lancet 1: 692PubMedCrossRefGoogle Scholar
  19. 19.
    Quenneville G, Barton B, McDevitt E, Wright IS (1959) The use of anticoagulants for thrombophlebitis during pregnancy. Am J Obstet Gynecol 77: 1135–1149PubMedGoogle Scholar
  20. 20.
    Warkany J (1975) A warfarin embryopathy? Am J Dis Child 129: 287–288PubMedGoogle Scholar
  21. 21.
    von Syndow G (1947) Hypoprothrombinemia and cerebral injury in infant after dicumarol treatment of mother. Nord Med 34: 1171–1172Google Scholar
  22. 22.
    Sach JJ, Labate JS (1949) Dicumarol in the treatment of antenatal thrombo-embolic disease: Report of a case with hemorrhagic manifestations in the fetus. Am J Obstet Gynecol 57: 965–971Google Scholar
  23. 23.
    Gordon RR, Dean T (1955) Fetal deaths from antenatal anticoagulant therapy. Br Med J 2: 719–721PubMedCrossRefGoogle Scholar
  24. 24.
    VillaSanta U (1965) Thromboembolic disease in pregnancy. Am J Obstet Gynecol 93; 142PubMedGoogle Scholar
  25. 25.
    Iturbe-Alessio I, del Carmen Fonseca M, Mutchinik O, Santos MA, Zajarias A, Salazar E (1986) Risks of anticoagulant therapy in pregnant women with artificial heart valves. N Engl J Med 315: 1390–1393PubMedCrossRefGoogle Scholar
  26. 26.
    Kakkar W (1975) Deep vein thrombosis. Detection and prevention. Circulation 51: 8–19PubMedCrossRefGoogle Scholar
  27. 27.
    Crawford JS (1978) Principles and practice of obstetrics anesthesia, 4th edn. Black-well Scientific Publications, Oxford, pp 182–183Google Scholar
  28. 28.
    Orme MLE, Lewis PJ, de Swiet M, Serlin MJ, Sibeon R, Baty JD, Breckenridge AM (1977) May mothers given warfarin breast-feed their infants? Br Med J 1: 1564–1565PubMedCrossRefGoogle Scholar
  29. 29.
    Hellgren M, Tenbgorn L, Abildgaard U (1982) Pregnancy in women with congenital antithrombin III deficiency: experience of treatment with heparin and antithrombin. Gynecol Obstet Invest 14: 127–141PubMedCrossRefGoogle Scholar
  30. 30.
    Hellgren M, Nygårds EB, Robbe H (1982) Antithrombin III in late pregnancy. Acta Obstet Gynecol Scand 61: 187–189PubMedCrossRefGoogle Scholar
  31. 31.
    Griffith GC, Nichols G, Asher JD, Hanagan B (1965) Heparin osteoporosis. JAMA 193: 91–94PubMedCrossRefGoogle Scholar
  32. 32.
    Wise PH, Hall AJ (1980) Heparin-induced osteopenia in pregnancy. Br Med J 281: 110–111PubMedCrossRefGoogle Scholar
  33. 33.
    Cines DB, Kaywin P, Bina M, Tomaski A, Schreiber AD (1980) Heparin-associated thrombocytopenia. N Engl J Med 303: 788–795PubMedCrossRefGoogle Scholar
  34. 34.
    Chong BH, Pitney WR, Castaldi PA (1982) Heparin-induced thrombocytopenia: an association of thrombotic complications with heparin-dependent IgG antibody that induces thromboxane synthesis and platelet aggregation. Lancet 2: 1246–1248PubMedCrossRefGoogle Scholar
  35. 35.
    Babcock RB, Wesley Dumper C, Scharfman WB (1976) Heparin-induced immune thrombocytopenia. N Engl J Med 295: 237–241PubMedCrossRefGoogle Scholar
  36. 36.
    de Swiet M, Bulpitt CJ, Lewis PJ (1980) How obstetricians use anticoagulants in the prophylaxis of thromboembolism. J Obstet Gynecol 1: 29–32CrossRefGoogle Scholar
  37. 37.
    Åstedt B (1988) Hemorrhagic diathesis due to pathological proteolysis. In: Renck H (ed) Bleeding and thrombotic disorders in the surgical patient. Appleton & Lange, Norwalk, pp 53–59Google Scholar
  38. 38.
    Svanberg L, Åstedt B, Nilsson IM (1980) Abruptio placenta—treatment with the fibrinolytic inhibitor tranexamic acid. Acta Obstet Gynecol Scand 59: 127–30PubMedCrossRefGoogle Scholar
  39. 39.
    Åstedt B, Nilsson IM (1978) Recurrent abruptio placentae treated with the fibrinolytic inhibitor tranexamic acid. Br Med J 1: 756–7PubMedCrossRefGoogle Scholar

Copyright information

© Springer Japan 1991

Authors and Affiliations

  • Birger Åstedt
    • 1
  1. 1.Department of Obstetrics and GynecologyUniversity HospitalLundSweden

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