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首页> 外文期刊>Journal of obstetrics and gynaecology: the journal of the Institute of Obstetrics and Gynaecology >Obstetric venous thromboembolism: a systematic review of dalteparin and pregnancy
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Obstetric venous thromboembolism: a systematic review of dalteparin and pregnancy

机译：产科静脉血栓栓塞：对丹麦肝素和怀孕的系统综述

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摘要

A systematic review of studies published between 1 January 1985 and 31 August 2017 was performed to analyse the efficacy of the low-molecular-weight heparin, dalteparin, in venous thromboembolism (VTE) treatment and prophylaxis during pregnancy, and to evaluate dosing practices, anticoagulant monitoring and adverse events. A therapeutic dosing throughout pregnancy or followed by reduced doses effectively prevented VTE recurrence. Anti-factor Xa activity was the most commonly used method of dose monitoring. The risk of bleeding with dalteparin was generally minor. Major bleeding was observed when a high dose of dalteparin was employed during (or close to) delivery, or postpartum. Other adverse events were minor. Disparity exists in VTE treatment and thromboprophylaxis, with wide variety in the dosing regimens, treatment strategies and monitoring practices employed. Large randomised controlled trials are warranted but due to ethical reasons, and the rarity of VTE-associated obstetric complications, case-control, registry and large observational studies present more likely options.
机译：对1985年1月1日至2017年8月31日至2017年8月31日发表的研究进行了系统审查，分析了妊娠期间低分子量肝素，丹麦肝素（VTE）治疗和预防的疗效，并评估了抗凝血剂的剂量措施监测和不良事件。在整个妊娠期间或随后减少剂量的治疗剂量有效地防止了VTE复发。抗因子Xa活性是最常用的剂量监测方法。用达尔特肝素出血的风险通常是较小的。当在（或接近）递送或产后使用高剂量的丹麦肝素时，观察到重大出血。其他不良事件是次要的。差距存在于VTE治疗和血浆前丙基，在给药方案中具有各种各样的种类，雇用治疗策略和监测实践。需要大规模的随机对照试验，但由于道德原因，以及VTE相关的产科并发症，案例控制，登记和大型观测性研究的罕见选择更有可能。

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