2023-06-18 02:53:06
Illustrated-The Invisible Killer of Pregnant Women! “Deep vein thrombosis” becomes “pulmonary embolism” and may be fatal
After pregnancy, the body will undergo a series of physiological changes, causing the blood of pregnant women to be in a state where blood is more likely to coagulate, so that postpartum uterine bleeding can be stopped quickly, but the disadvantage is that the risk of thrombosis in pregnant women is 4 to 5 times that of ordinary women , especially in the postpartum period, the risk is increased by up to 20 times! Li Jiajie, attending physician of Obstetrics and Gynecology at Cathay Pacific General Medicine, said that deep vein embolism during pregnancy is common in the lower extremities. If the thrombus in the lower extremities falls, it may travel along the blood flow to the lungs and form fatal pulmonary embolism.
The incidence of thrombosis during pregnancy is about 0.5-2/1000, and 80% of pregnancy-related thrombosis diseases are venous thrombosis. Eighty percent of these venous embolisms were deep vein embolisms and 20 percent were pulmonary embolisms. Deep vein thrombosis during pregnancy is common in the lower extremities. If the thrombus in the lower extremities falls, it may follow the blood flow to the lungs and form fatal pulmonary embolism.
The risk of caesarean section is high, the most dangerous within 3 months after delivery
Venous thromboembolic disease is one of the most common causes of maternal death in the United States, with an incidence of approximately 1.1 per 100,000 births; and accounts for approximately 9-10% of maternal deaths. Mothers who delivered by caesarean section are about 2-4 times more likely than mothers who delivered vaginally. In addition, if you need to stay in bed for a long time during pregnancy, it is also one of the high-risk factors.
The probability of thrombosis increases with gestational age, and even within 3 months after delivery, it is a high-risk period. Proportionally, about half of the blood clots occurred during pregnancy, and the other half occurred within 3 months after delivery, with the highest risk occurring in the first week after delivery.
Clinical symptoms of deep vein thrombosis:
Unilateral or bilateral lower extremity swelling, pain, fever, redness, edema and tenderness
Clinical manifestations of pulmonary embolism:
Difficulty or rapid breathing, rapid heartbeat, coughing and coughing up blood, chest pain, dizziness, headache or fainting, and possibly death.
High-risk groups should be careful:
caesarean section
diabetes or gestational diabetes
antepartum hemorrhage
multiple births
hyperemesis gravidarum
multipartum
Chronic hypertension or pregnancy-related hypertensive disorder
puerperal infection
stillbirth
postpartum hemorrhage
connective tissue disease
previous history of thrombosis
Cardiovascular diseases
Long-term miscarriage, low activity
obesity
premature water break
sickle cell anemia
lupus disease
smokes
nephrotic syndrome
antiphospholipid syndrome
history of blood related diseases
According to the 2018 American College of Obstetricians and Gynecologists (ACOG) recommendations, all pregnant women who have a C-section should use a pneumatic compression system and get out of bed as soon as possible after the procedure. Intermittent pneumatic compression system is a physical treatment method. In a non-invasive way, the air bag inflates and contracts through the foot cover to promote blood circulation, help venous blood return to the heart, avoid blood accumulation, and reduce venous embolism and pulmonary embolism. risk. And it also has the function of reducing edema of lower extremities.
Li Jiajie explained that for high-risk pregnant women, in addition to using anticoagulants to prevent venous thrombosis, studies have confirmed that the use or combination of pneumatic compression systems can effectively reduce the probability of thrombosis. In order to avoid hemorrhage during and after delivery, pregnant women who are taking anticoagulants are usually advised to stop using anticoagulants for about 1 week before and after delivery. At this time, the physical method of pneumatic compression system can be used to prevent thrombosis, and it can be used until ambulation or anticoagulant can be resumed. For example, the hospital has introduced medical devices approved by the US Food and Drug Administration (FDA) for the prevention of deep vein thrombosis of the lower extremities, in order to provide safer delivery for pregnant women.
Original source:Invisible Killer Maternal Deep Vein Thrombosis and Pulmonary Embolism
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