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Thrombotic risk management before and during pregnancy

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Vital issues about thrombotic risc in pregnancy, is thrombophilia an obstacle for assisted reproduction?

Description

Thrombotic risk management before and during pregnancy is an important medical issue that should be taken into consideration by gynecologists. 

 

CredoMedia India starts a discussion about this crucial issue. We would like to discuss the following key points:

 

 

  • When is a coagulation status test necessary when a patient is planning  pregnancy or is already pregnant?
  • Are conception and successful carriage of the fetus possible in cases of inherent or acquired thrombophilia?
  • Is thrombophilia an obstacle for assisted reproduction?
  • What is the risk of placental capillaries thrombosis in women with thrombophilia in comparison with women without that condition?
  • What is the effect of auxiliary hormonal treatment on micro- and macro thrombotic risk during assisted reproduction?
  • What are the drug application methods in hypercoagulable state management?
  • Medication administration algorithms of low-molecular heparin
  • Laboratory and clinical control of low-molecule heparin treatment
  • Are there any drug interactions – how are they manifested and managed?
  • The role of combined treatment – low-molecular heparin, acetylsalicylic acid etc.
  • Duration of low-molecular heparin treatment and cases when it is necessary during assisted reproduction or when trying to conceive naturally after a miscarriage

 We would like to invite all obstetrics and gynecology doctors specialized in assisted reproduction. We would be glad if you would share your opinion, comment or share a case study from your practice.

 

The discussion starts on the 1st of April and will be open for one month. 

 

 


 [PD1]

 

7
Participants
9
Comments

Comments

17 May 2018 14:57
Ashwini Anil Shedge
17 May 2018 14:57

abcd

30 Mar 2018 13:37
CredoMedia India
30 Mar 2018 13:37
30 Mar 2018 11:36
CredoMedia India
30 Mar 2018 11:36

There may be a ticking time bomb in your veins. It’s rare, potentially deadly, hereditary, and worst of all, it’s most dangerous to expecting and new mothers. It’s called Hereditary Antithrombin (AT) Deficiency. It is among the rarest, most dangerous, and most underdiagnosed of all inherited blood clotting disorders. And it’s highly unlikely that your OBGYN will test you for it. The statistics are sobering: patients with Hereditary AT Deficiency have a 20-times higher risk of blood clots, such as deep vein thrombosis (DVT) or pulmonary embolism (PE). One in three pulmonary embolisms may be fatal. Unfortunately if you’re pregnant, the risk increases even further. In fact, up to 70% of women with Hereditary AT Deficiency who do not receive preventative treatment may experience blood clotting before or after childbirth. The greatest risk is in the first week post-partum.

30 Mar 2018 11:34
CredoMedia India
30 Mar 2018 11:34
30 Mar 2018 11:29
CredoMedia India
30 Mar 2018 11:29

This comment was deleted by its author

30 Mar 2018 11:24
CredoMedia India
30 Mar 2018 11:24

This comment was deleted by its author

30 Mar 2018 11:04
CredoMedia India
30 Mar 2018 11:04

Colleagues, we would like to raise in the discussion the following question: Does fertility therapy increase the risk of longer term cardiovascular outcomes?

29 Mar 2018 12:23
Anonymous
29 Mar 2018 12:23

Very well

28 Mar 2018 15:05
CredoMedia India
28 Mar 2018 15:05

This comment was deleted by its author

28 Mar 2018 15:04
CredoMedia India
28 Mar 2018 15:04

This comment was deleted by its author

28 Mar 2018 15:02
CredoMedia India
28 Mar 2018 15:02


We would like to quote the results of an US review "Thrombophilia and assisted reproduction technology—any detrimental impact or unnecessary overuse".
The conclusions in the review are that current evidence does not support routinely testing for or treatment of thrombophilia in the setting of ART nor in couples with implantation failure. A careful personal and family history should be obtained, the study recommends.  

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5065550

28 Mar 2018 14:54
CredoMedia India
28 Mar 2018 14:54

Pregnancy is a state that conveys 4-5 times the risk of venous thromboembolism (VTE). The prevalence of VTE in pregnancy is 0.8-2.0 per 1,000 pregnancies and accounts for 1.1 deaths per 100,000 pregnancies.  Approximately 80% of embolic events in pregnancy are venous.

The most important risk factor for a women experiencing pregnancy-related VTE is prior personal history of VTE.  The second most common risk factor is thrombophilia,  which is present in 8%-15% of whites. Although most patients with thrombophilias never develop VTE, at least 20%, and possibly over 50%, of pregnant patients diagnosed with VTE have a thrombophilia.