Pregnancy and thrombosis: Adrenal vein thrombosis. A retrospective descriptive study of 14 cases
| Autor: | Muriel Doret, Catherine Battie, Cyril Huissoud, Pierre Descargues, Yesim Dargaud, Nathalie Hoen, Pascal Gaucherand |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
medicine.medical_specialty medicine.drug_class Pregnancy Trimester Third Low molecular weight heparin Gestational Age Thrombophilia 03 medical and health sciences Young Adult 0302 clinical medicine Pregnancy Recurrence Adrenal Glands medicine Secondary Prevention Humans 030212 general & internal medicine Renal colic Hemostatic function Retrospective Studies Ultrasonography Venous Thrombosis 030219 obstetrics & reproductive medicine medicine.diagnostic_test business.industry Pregnancy Complications Hematologic Obstetrics and Gynecology Gestational age Anticoagulants Heparin Low-Molecular-Weight medicine.disease Thrombosis Surgery Reproductive Medicine Abdominal ultrasonography Female medicine.symptom business Tomography X-Ray Computed |
| Zdroj: | European journal of obstetrics, gynecology, and reproductive biology. 233 |
| ISSN: | 1872-7654 |
| Popis: | Objectives Adrenal vein thrombosis during pregnancy is a rare thromboembolic event but is not exceptional. The objective of this study was to described the symptoms, diagnosis, treatment and follow-up of patients with this condition. Study design This was a retrospective descriptive study of 14 cases (13 patients, one recurrence) that occurred in the three university maternity hospitals in Lyon (France) from 2008 to 2016. Results Adrenal vein thrombosis occurred exclusively in the third trimester (gestational age > 28 weeks), with most patients presenting unilateral lumbar pain (13/14 cases, 93%) and vomiting (8 cases, 57%), mimicking renal colic. To establish the diagnosis, all patients were examined by abdominal CT and all but three (79%) by abdominal ultrasonography. Ten patients (71%) were treated by low molecular weight heparin and the remaining four (29%) by unfractionated heparin. The delay between presentation and diagnosis, and thus before treatment was initiated, was greater than 24 h in 50% of cases. Thrombosis occurred predominantly (11 vs 3 cases) on the right adrenal vein. Labor inducing or cervical ripening agents were used after temporarily interrupting treatment for 9/14 patients (64%). Epidural anesthesia was possible for 11 patients (79%) and 2 (14%) had postpartum hemorrhage. Eleven patients received hemostatic function investigations with anomalies detected in four cases (36%). One of the six patients (16%) who had a second full-term pregnancy during the study period had a contralateral recurrence. Conclusions Adrenal vein thromboses are rare events requiring curative anticoagulant therapy and labor management to minimize the risk of hemorrhage. Patients should receive thromboprophylaxis for subsequent pregnancies and a full thrombophilia investigation. |
| Databáze: | OpenAIRE |
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