ASSESSING THE ACTUAL APPLICATION OF CLINICAL GUIDELINES FOR PREVENTING VENOUS THROMBOEMBOLIC COMPLICATIONS DURING PREGNANCY, CHILDBIRTH, AND POSTPARTUM PERIOD

UDC 618.3:618.56-005.6-005.7

Authors

DOI:

https://doi.org/10.31684/25418475-2023-2-116

Keywords:

pregnancy, venous thromboembolic complications, low molecular weight heparins, postpartum period, clinical guidelines

Abstract

Given the critical nature of venous thromboembolic complications (VTEC) in pregnant women, it is vital to review the preventive strategies for deep vein thrombosis and pulmonary embolism during pregnancy, delivery, and the early postpartum period, as outlined by the current clinical guidelines in the Russian Federation. Through our own experience with these guidelines, we have come to the realization that a dynamic assessment of VTEC risk, along with a personalized approach to prescribing antithrombotic agents throughout gestation and the postpartum phase, is indispensable.

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Margarita D. Andreeva,
Kuban State Medical University, Krasnodar

Dr. Sci. (Med.), Professor, Department of Obstetrics, Gynecology and Perinatology, FPC and PPS, Kuban State Medical University, Krasnodar.
E-mail: corpus@ksma.ru
https://orcid.org/0000-0002-6524-3965

Denis V. Frolov,
Volgograd State Medical University, Volgograd

Dr. Sci. (Med.), Professor, Department of General Surgery, Volgograd State Medical University, Volgograd.
E-mail: gensurg1@yandex.ru
https://orcid.org/0000-0002-0018-9822

Darya A. Yakovleva,
Clinical Hospital No. 5, Volgograd

Obstetrician-Gynecologist, Volgograd City Hospital No. 5, Volgograd.
E-mail: darja.yakovleva2013@yandex.ru
https://orcid.org/0000-0003-3966-8086

Emmanuella A. Bayanduryan,
Anapa City Hospital, Anapa

Obstetrician-Gynecologist, City Hospital of Anapa, Krasnodar Krai, Anapa.
https://orcid.org/0000-0003-0227-2598
E-mail: corpus@ksma.ru

References

  • Lutsey P.L., Zakai N.A. Epidemiology and prevention of venous thromboembolism. Nat Rev Cardiol. 2022; Oct 18: 1-15. https://doi.org/10.1038/s415-022-00787-6.
  • Nichols K.M., Henkin S., Creager M.A. Venous thromboembolism associated with pregnancy: JACC focus seminar. J Am Coll Cardiol. 2020; 76(18): 2128-2141. https://doi.org/10.1016/j.jacc.2020.06.090;
  • Momot A.P. Nikolaeva M.G., Serdyuk G.V. et al. Assessment of the hemostasis system in physiologically occurring pregnancy. Algorithms of examination in risk groups. Thrombosis, hemostasis, and rheology. 2019; 4(80): 80-130. https://doi.org/10.25555/THR.2019.4.0903. [In Russ.]
  • Alshaikh N.A. Protein S: a central regulator of blood coagulation. Clin Lab. 2022; 68(8). https://doi.org/10.7754/Clin.Lab.2021.211010.
  • Malm J., Laurell M., Dahlbäck B. Changes in the plasma levels of vitamin K-dependent proteins C and S and of C4b-binding protein during pregnancy and oral contraception. Br J Haematol. 1988; 68(4): 437-443. https://doi.org/10.1111/j.1365-2141.1988.tb04232.x.
  • Soma-Pillay P., Nelson-Piercy C., Tolppanen H., Mebazaa A. Physiological Changes in pregnancy. Cardiovasc J Afr. 2016; 27(2): 89-94. https://doi.org/10.5830/CVJA-2016-021.
  • Bukhari S., Fatima S., Barakat A.F., et al. Venous thromboembolism during pregnancy and postpartum period. Eur J Intern Med. 2022; 97: 8-17. https://doi.org/10.1016/j.ejim.2021.12.013.
  • Edebiri O., Áinle F.N. Risk factors, diagnosis and management of venous thromboembolic disease in pregnancy. Breath (Sheff). 2022; 18(2): 220018. https://doi.org/10.1183/20734735.0018-2022.
  • Venous complications during pregnancy and the postpartum period. Obstetric thromboembolism. Clinical guidelines. 2021. [In Russ.]
  • Padda J., Khalid K., Mohan A., Pokhriyal S., Batra N., Hitawala G., et al. Factor V Leiden G1691A and prothrombin gene G2021A mutations on pregnancy outcome. Cureus. 2021; 13(8): e17185. https://doi.org/10.7759/cureus.17185.
  • Mitric D., Popusoi O., Catrinici R., Friptu V. The obstetric complications in women with hereditary thrombophilia. Med Pharm Rep. 2019; 92(2): 106-110. https://doi.org/10.15386/cjmed-1097.
  • Arachchilage D.J., Mackillop L., Chandratheva A., Motawani J., MacCallum P., Laffan M. Thrombophilia testing: a British society for haematology guideline. Br J Haematol. 2022; 198(3): 443-458. https://doi.org/10.1111/bjh.18239.
  • Nikolaeva M.G. Serdyuk G.V., Momot K.A., Yasafova N.N., Momot A.P., Yelykomov V.A. APS resistance associated with factor V Leiden mutation (genotype GA): clinical realization in pregnancy. Thrombosis, hemostasis and rheology. 2018; 73(1): 47-54. [In Russ.]
  • Shmakov R.G., Pyregov A.V., Vavilova T.V. Venous complications during pregnancy and the postpartum period. obstetric thromboembolism. Clinical guidelines. Coded according to the International Statistical Classification of Diseases and Related Health Problems O22/O87/O88. Age group: adults/children. Moscow, 2021. [In Russ.]
  • Momot A.P., Nikolaeva M.G. Thrombophilias in obstetric and gynecological practice. Heparinoprophylaxis. Medical Council 2017; 13: 71-78. https://doi.org/10.21518/2079-701X-2017-13-71-78. [In Russ.]
  • Waters J.H. The role of viscoelastic testing in the management of parturient. Transfusion. 2020; 60 Suppl 6: S70-S74. https://doi.org/10:1111/trf.15928.
  • Cohen S.L., Feizullayeva C., McCandlish J.A., Sanelli P.C., McGinn T., Brenner B., et al. Comparison of international societal guidelines for the diagnosis of suspected pulmonary embolism during pregnancy. Lancet Haematol. 2020; 7(3): e247-e258. https://doi.org/10.1016/S2352-3026(19)30250-9.
  • Bai C., Wu H., Wu W., Feng P., Nie M., Zhao L., Meng F. Anticoagulation for mechanical heart valves during pregnancy: a case report and literature review. Medicine (Baltomore). 2022; 101(52): e32550. https://doi.org/10.1097/MD.0000000000032550
  • Middleton P., Shepherd E., Gomersall J.C. Venous thromboembolism prophylaxis for women at risk during pregnancy and at the early postnatal period. Cochrane Database. 2021; 3(3): CD001689. https://doi.org/10.1002/14651858.CD001689.
  • Chau C., Campagna J., Vial M., Rambeaud C., Loundou A., Bretelle F. Use of a personalized iterative score to evaluate risk of venous thromboembolism during pregnancy and pierperium. Int J Gynaecol Obstet. 2019; 144(3): 277-282. https://doi.org/10.1002/ijgo.12754.
  • Wiegers H.M., Middeldorp S. Contemporary best practice in the management of pulmonary embolism during pregnancy. Ther Adv Respir Dis. 2020; 14: 1753466620914222. https://doi.org/10.1177/1753466620914222.
  • Wan T., Skeith L., Karovitch A., Rodger M., Le Gal G. Guidance for the diagnosis of pulmonary embolism during pregnancy: consensus and controversies. Thromb Res. 2017; 157: 23-28. https://doi.org/10.1016/j.thromres.2017.06.025.
  • Robert-Ebadi H., Moumneh T., Le Gal G., Righini M. Diagnosis of pulmonary embolism during pregnancy. Diagnostics (Basel). 2022; 12(8): 1875. https://doi.org/10.3390/diagnostics12081875.
  • American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 196: Thromboembolism in Pregnancy. Obstet Gynecol. 2018; 132(1): e1-e17. https://doi.org/10.1097/AOG.0000000000002706.
  • Bates S.M., Rajasekhar A., Middeldorp S., McLintock C., Rodger M.A., James A.H., et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: venous thromboembolism in the context of pregnancy. Blood Adv. 2018; 2(22): 3317-3359. https://doi.org/10.1182/bloodadvances.2018024802.
  • Boban A., Paulus S., Lambert C., Hermans C. The value and impact of anti-Xa activity monitoring for prophylactic dose adjustment of low-molecular-weight heparin diring pregnancy: a retrospective study. Blood Coagul Fibrinolysis. 2017; 28(3): 199-204. https://doi.org/10.1097/MBC.0000000000000573.
  • Aggarwal S.R., Economy K.E., Valente A.M. State of art management of mechanical heart valves during pregnancy. Curr Treat Options Cardiovasc Med. 2018; 20(12): 102. https://doi.org/10.1007/s11936-018-0702-3.
  • Keepanasseril A., Pilai A.A., Baghel J., Pande S.N., Mondal N., Munuswamy H., et al. Alternatives to low molecular weight heparin for anticoagulation in pregnant women with mechanical heart valves in middle-income countries: a cohort study. Glob Heart. 2021; 16(1): 68. https://doi.org/10.5334/gh.1011.
  • Lameijer H., Aalberts J.J., van Veldhuisen D.J., Meijer K., Pieper P.G. Efficacy and safety of direct oral anticoagulants during pregnancy: a systemic literature review. Thromb Res. 2018; 169: 123-127. https://doi.org/10.1016/thromres.2018.07.022.
  • Muysson M., Marshall K., Datta P., Rewers-Felkins K., Baker T., Hale T.W. Rivaroxaban treatment in two breastfeeding mothers: a case series. Breastfeed Med. 2020; 15(1): 41-43. https://doi.org/10.1089/bfm.2019.0124.
  • Andreeva M.D., Karakhalis L.Y., Penzhoyan G.A., Shapovalova O.A., Vysotsky O.V., Penzhoyan M.A. Delivery in conditions of COVID-19 infection: a clinical observation. Obstetrics and gynecology: news, opinions, training. 2020; 8(2): 25-35. https://doi.org/10.24411/2303-9698-2020-12001. [In Russ.]
  • Lee M-S., Chen W., Zhang Z., Duan L., Ng A., Spencer H.T., et al. J Am Heart Assoc. 2016; 5(4): e003182. https://doi.org/10.1161/JAHA.115.003182.
  • Georgiopolous G., Tsiachris D., Kordalis A., Kontogiannis C., Spartalis M., Pietri P., et al. Pharmacotherapeutic strategy for atrial fibrillation in pregnancy. Expert Opin Pharmacother. 2019; 20(13): 1625-1636. https://doi.org/10.1080/14656566.2019.1621290.
  • Lang I.M., What is new in the 2018 ESC guidelines for the management of cardiovascular diseases during pregnancy? Wien Klin Wochenschr. 2020; 132(3-4): 69-72. https://doi.org/10.1007/s00508-019-1529-y.
  • Struk R.I., Bunin Y.A., Gurieva V.M., Irtyuga O.B., Kokov L.S., Kolomatzkaya O.E. et al. Diagnosis and treatment of cardiovascular diseases in pregnancy. 2018. National recommendations. Russian Journal of Cardiology. 2018; 3(155): 91-134. https://doi.org/10.15829/1560-4071-2018-3-91-134. [In Russ.]

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    2023-06-26

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    Andreeva M. D., Frolov D. V., Yakovleva D. A., Bayanduryan E. A. ASSESSING THE ACTUAL APPLICATION OF CLINICAL GUIDELINES FOR PREVENTING VENOUS THROMBOEMBOLIC COMPLICATIONS DURING PREGNANCY, CHILDBIRTH, AND POSTPARTUM PERIOD: UDC 618.3:618.56-005.6-005.7 // Bulletin of Medical Science, 2023. Vol. 30, № 2. P. 116–122 DOI: 10.31684/25418475-2023-2-116. URL: https://newbmn.asmu.ru/bmn/article/view/579.

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    Vol. 30 No. 2 (2023): Bulletin of Medical Science

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    REVIEWS

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    Copyright (c) 2023 Маргарита Дарчоевна Андреева, Денис Владимирович Фролов, Дарья Андреевна Яковлева, Эммануелла Ашотовна Баяндурян

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