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Incidence of postpartum thrombosis and preterm delivery in women with antiphospholipid antibodies and recurrent pregnancy loss.

https://arctichealth.org/en/permalink/ahliterature164295
Source
J Rheumatol. 2007 May;34(5):992-6
Publication Type
Article
Date
May-2007
Author
Christine A Clark
Karen A Spitzer
Mark A Crowther
Jamie N Nadler
Matthew D Laskin
Joshua A Waks
Carl A Laskin
Author Affiliation
Department of Medicine, University of Toronto, Toronto, Canada.
Source
J Rheumatol. 2007 May;34(5):992-6
Date
May-2007
Language
English
Publication Type
Article
Keywords
Abortion, Habitual - blood - epidemiology
Adult
Antibodies, Anticardiolipin - blood
Antibodies, Antiphospholipid - blood
Canada - epidemiology
Comorbidity
Female
Humans
Incidence
Postpartum Period
Pregnancy
Premature Birth - blood - epidemiology
Puerperal Disorders - blood - epidemiology
Venous Thrombosis - blood - epidemiology
Abstract
To determine the frequency of preterm deliveries and postpartum thrombotic events (TE) in pregnancies resulting in live birth in women with antiphospholipid antibodies (aPL) and a history of recurrent pregnancy loss (RPL) but without prior TE.
We reviewed the pregnancy outcomes of women referred to our clinic with a history of RPL. Prepregnancy investigation of RPL included history of TE and aPL positivity (anticardiolipin IgG and lupus anticoagulant). We recorded use of anticoagulation therapy during and after pregnancy, obstetric outcome, gestational age at delivery, and postpartum course. Included in our study were women with unexplained RPL with no history of TE attending our clinic who subsequently had pregnancies that resulted in a live birth.
Over a 5-year period, 260 women with RPL and no history of TE had a live birth at our clinic. Eighty-seven (33.5%) were positive for aPL and 173 (66.5%) were negative for aPL. Twenty-four percent of deliveries in the aPL-positive group occurred before 37 weeks' gestation compared to 9.8% of deliveries in the aPL-negative group (p = 0.004; 95% CI 0.052-0.234). There were no antepartum TE in either group. One woman in the aPL-positive group (1.1%) had a deep vein thrombosis 3.5 weeks postpartum while receiving prophylactic anticoagulant therapy, compared to none in the aPL-negative group.
A significantly higher proportion of aPL-positive patients had preterm deliveries compared to aPL-negative patients, but pregnancy-related TE was infrequent: 99.0% of aPL-positive women with a history of RPL and no prior TE who had a live birth at our clinic had an uneventful pregnancy, delivery, and postpartum course.
PubMed ID
17407219 View in PubMed
Less detail

Management and adherence to VTE treatment guidelines in a national prospective cohort study in the Canadian outpatient setting. The Recovery Study.

https://arctichealth.org/en/permalink/ahliterature122728
Source
Thromb Haemost. 2012 Sep;108(3):493-8
Publication Type
Article
Date
Sep-2012
Author
Susan R Kahn
Vicky Springmann
Sam Schulman
Josée Martineau
John A Stewart
Nelly Komari
Anne McLeod
Carla Strulovitch
Mark Blostein
Jacques-Philippe Faucher
Greg Gamble
Wendy Gordon
Peter K Kagoma
Marie-José Miron
David Laverdière
Melaku Game
Allan Mills
Author Affiliation
Centre for Clinical Epidemiology, Jewish General Hospital, Montreal, Quebec, Canada. susan.kahn@mcgill.ca
Source
Thromb Haemost. 2012 Sep;108(3):493-8
Date
Sep-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Anticoagulants - adverse effects - therapeutic use
Canada - epidemiology
Catheterization - adverse effects
Coumarins - adverse effects - therapeutic use
Disease Management
Drug Utilization - statistics & numerical data
Enoxaparin - adverse effects - therapeutic use
Estrogens - adverse effects
Female
Hemorrhage - chemically induced - epidemiology
Hormone Replacement Therapy - adverse effects
Humans
Male
Medication Adherence - statistics & numerical data
Middle Aged
Neoplasms - complications
Outpatient clinics, hospital - statistics & numerical data
Physician's Practice Patterns - statistics & numerical data
Practice Guidelines as Topic
Pregnancy
Pregnancy Complications, Hematologic - drug therapy
Prospective Studies
Puerperal Disorders - blood - drug therapy
Recurrence - prevention & control
Risk factors
Thrombophilia - drug therapy - etiology - genetics
Venous Thromboembolism - drug therapy - etiology - prevention & control
Abstract
Documenting patterns and outcomes of venous thromboembolism (VTE) management and degree of adherence by clinicians to treatment guidelines could help identify remediable gaps in patient care. Prospective, clinical practice-based data from Canadian outpatient settings on management of VTE, degree of adherence with treatment guidelines and frequency of recurrent VTE and bleeding during follow-up was obtained in a multicentre, prospective observational study. From 12 Canadian centres, we assessed 868 outpatients with acute symptomatic VTE who received the low-molecular-weight heparin (LMWH) enoxaparin alone or with vitamin K antagonists (VKA), at baseline and at six months (or at the end of treatment, whichever came first). Index VTE was limb deep venous thrombosis (DVT) in 583 (67.2%) patients, pulmonary embolism (PE) with or without DVT in 262 (30.2%) patients, and unusual site DVT in 23 (2.6%) patients. VTE was unprovoked in 399 (46.0%) patients, associated with cancer in 74 (8.5%) patients, transient risk factors in 327 (37.7%) patients and hormonal factors in 68 (7.8%) patients.With regard to guideline adherence, 58 (7.3%) patients received 3 months. Only 38.1% of patients with transient VTE risk factors had received thromboprophylaxis. Our study provides useful information on clinical presentation, management and related outcomes in Canadian outpatients with VTE. Our results suggest there may be important gaps in use of thromboprophylaxis to prevent VTE and use of LMWH monotherapy to treat cancer-related VTE.
PubMed ID
22782073 View in PubMed
Less detail

[The state of the adaptation system of women during the postpartum period under the influence of an industrial complex]

https://arctichealth.org/en/permalink/ahliterature10159
Source
Gig Sanit. 2001 May-Jun;(3):32-4
Publication Type
Article
Author
G A Kulkybaev
Kh D Diusembin
A E Konkabaeva
Source
Gig Sanit. 2001 May-Jun;(3):32-4
Language
Russian
Publication Type
Article
Keywords
Adaptation, Physiological
Adult
Comparative Study
Dihydroxyphenylalanine - blood
Dopamine - blood
English Abstract
Environmental Pollutants - adverse effects
Epinephrine - blood
Female
Humans
Hydrocortisone - blood
Metallurgy
Mining
Norepinephrine - blood
Puerperal Disorders - blood - etiology - physiopathology
Siberia
Stress - blood - etiology - physiopathology
Thyroid Hormones - blood
Time Factors
Abstract
The hormonal status was studied in the dynamics of postpartum stress in the puerperas who lived in the town of Balkhash under the influence of an industrial complex. The puerperas were found to show no pronounced adrenal cortical response to postpartum stress; there was monotony of changes in the content of dopa and dophamine and the levels of adrenaline and noradrenaline remained high on day 5 after delivery as compared with the controls. There were high levels of prolactin and cortisole, which suggests different stress levels in Balkhash females and in the controls. It can be assumed that chronic exposure to industrial noxious agents results in so-called cross resistance caused by one stressor (delivery) in relation to the effect of other-order (ecological) stressors rather than in depletion of the hormonal system.
PubMed ID
11519456 View in PubMed
Less detail

[The state of the coagulation and anticoagulation system of the blood in pregnant, parturients and puerperal women with arterial hypotension]

https://arctichealth.org/en/permalink/ahliterature66851
Source
Pediatr Akus Ginekol. 1967 Mar-Apr;2:45-9
Publication Type
Article