Gebelikte Antikoagulasyon

Amaç: Gebelik sırasında antikoagülan ilaç kullanımı, plasenta kaynaklı komplikasyonları azaltmak, antifosfolipid sendromu, venöz tromboemboli veya mekanik kalp kapağı olan gebe hastalar gibi durumlarda zorunlu olmaktadır. Bu yazıda gebelikte kullanılabilen antikoagülan ilaçlar hakkında genel bilgi verilmesi amaçlanmaktadır.
Anahtar Kelimeler:

Gebelik, antikoagülan ilaçlar

Anticoagulation During Pregnancy

Aim: Anticoagulation medication during pregnancy becomes necessary in cases to reduce plasenta oriented complications, antiphospholipid synrome, venous thromboembolism or pregnant patients with mechanical heart valves.This report aims to review the anticoagulation drugs that can be used during pregnancy.

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  • 1.Punnialingam S, Khamashta MA. Duration of anticoagulation treatment for thrombosis in APS:is it ever safe to stop?Curr Rheumatol Rep 2013;15(4):318.
  • 2.Gris JC, Lissalde-Lavigne G, Quere I, Mares P. Monitoring the effects and managing the side effects of anticoagulation during pregnancy. Obstet Gynecol Clin N Am 2006;33:397-411.
  • 3.Hall JG.Embryopathy associated with oral anticoagulant therapy. Birth Defects 1965;12:133-40.
  • 4.Van Driel D,Wesseling J, Sauer PJ, Touwen BC, van der Veer E, Heymans HS. Teratogen update:fetal effects after in utero exposure to coumarins overview of cases, follow-up findings, and pathogenesis. Teratology 2002;66:127-40.
  • 5.Hall JG, Pauli RM, Wilson KM. Maternal and fetal sequelae of anticoagulation during pregnancy. Am J Med 1980;68:122-40.
  • 6.Iturbe-Alessio I, Fonseca MC, Mutchinik O,Santos MA, Zajarias A, Salazar E. Risks of anticoagulant therapy in pregnant woman with artificial heart valves. N Engl J Med 1986;315:1390-93.
  • 7.Chan WS, Anand S, Ginsberg JS. Anticoagulation of pregnant women with mechanical heart valves: a systematic review of the literature. Arch Intern Med 2000;160:191-96.
  • 8.Hung L, Rahimtoola SH. Prosthetic heart valves and pregnancy. Circulation 2003; 107:1240-6.
  • 9.Trimm JR, Hung L, Rahimtoola SH. Artificial heart valves. In: Oakley C,Warnes CA, eds. Heart Disease in Pregnancy. 2nd ed. Blackwell Publishing; p.104-21.
  • 10.Bates SM, Greer IA, Hirsch J, Ginsberg JS. Use of antithrombotic agents during pregnancy:the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004;126:627S-644S.
  • 11.Van Driel D, Wesseling J, Huurne K,Geven-Boere LM, Rosendaal FR, Veer E, et al. Adherence to a guideline for coumarins in pregnancy. Pharm World Sci 2004;26:297-300.
  • 12.Bergqvist D. Update on in hospital VTE prophylaxis. Eur J Vasc Endovasc Surg 2007;33(3):343-50.
  • 13.Casele HL. The use of unfractionated heparin and low molecular weight heparins in pregnancy. Clin Obstet Gynecol 2006;49(4):895-905.
  • 14.Clark NP, Delate T, Cleary SJ, Witt DM. Unfractionated heparin dose requirements targeting intermediate intensity antifactor Xa concentration during pregnancy. Pharmacotherapy 2010;30(4):369-74.
  • 15.Hirsh J, Bauer K, Donati M, Gould M, Samama M, Weitz J.Parenteral anticoagulants.American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008;133:141-59
  • 16.Gurbuz AT, Elliott WG, Zia AA. Heparin-induced trombocytopenia in the cardiovascular patient:diagnostic and treatment guidelines. Eur J Cardiothorac Surg 2005;27:138- 49.
  • 17.Warkentin TE, Greinacher A.Heparin-induced trombocytopenia and cardiac surgery. Ann Thorac Surg 2003;76:2121-31.
  • 18.Thielmann M, Bunschkowski M, Tossios P, Selleng S, Marggraf G, Greinacher A,et al. Perioperative trombocytopenia in cardiac surgical patients-incidence of heparin-induced trombocytopenia, morbidities and mortality. Eur J Cardiothorac Surg 2010, 37(6):1391-5.
  • 19.Hammon J Wi . Extracorporeal Circulation: The Response of Humoral and Cellular Elements of Blood to Extracorporeal Circulation. Cohn Lh, ed. Cardiac Surgery in the Adult. New York: McGraw-Hill, 2008:370-89. Chapter 12B.
  • 20.Koster A, Dyke CM, Aldea G, Smedira NG, McCarthy HL, Aronson S,et al. Bivalirudin during cardiopulmonary bypass in patients with previous or acute heparin-induced trombocytopenia and heparin antibodies:Results of the Choose-on Trial. Ann Thorac Surg 2007;83:572- 7.
  • 21.Weitz JI. Low molecular weight heparins. NEJM 1997;337:688-698.
  • 22.Duhl AJ, Paidas MJ,Ural SH, Branch W, Casele H, Cox-Gill J,et al. Antithrombotic teraphy and pregnancy:concensus report and recommendations for prevention and treatment of venous thromboembolism and adverse pregnancy outcomes. Am J Obstet Gynecol 2007;197:457e1-457e21.
  • 23.Knol HM, Schultinge L, Veeger NJ, Kluin-Nelemans HC, Erwich JJ, Meijer K. The risk of postpartum hemorrhage in women using high dose of low-molecular-weight heparins during pregnancy.Thromb Res 2012 Sep;130(3):334-8.
  • 24.Silver RM.New anticoagulants and pregnancy. Obstet Gynecol 2008; 112(2):part 2.
  • 25.Libby E. Pregnancy and thromboembolic disease. Thrombosis Research 2008;123, 55- 557.
  • 26.James AH. Pregnancy and thrombotic risk. Crit Care Med 2010;38(2)(Suppl): S57- S63.
Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi-Cover
  • Yayın Aralığı: 4
  • Başlangıç: 2004
  • Yayıncı: -
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