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Tromboprofilaxis durante el embarazo
Thromboprophylaxis during pregnancy
DOI:
https://doi.org/10.15446/revfacmed.v68n2.73366Palabras clave:
Trombosis venosa, Embarazo, Agentes antitrombóticos (es)Venous Thrombosis, Pregnancy, Antithrombotic Agents (en)
Introducción. En mujeres, el riesgo de desarrollar enfermedad tromboembólica venosa (ETV) es 5 a 6 veces mayor durante el embarazo, riesgo que puede aumentar considerablemente si existen antecedentes personales o familiares de otros estados protrombóticos. La ETV es una de las principales causas de morbimortalidad en esta población, por lo que para evaluar la pertinencia de usar tromboprofilaxis, ya sea farmacológica o no farmacológica, es necesario reconocer oportunamente los factores de riesgo clínico asociados a esta condición.
Objetivo. Describir el uso de pruebas de tamizaje de estados protrombóticos y de la tromboprofilaxis farmacológica y no farmacológica para prevenir la ETV durante la gestación, durante el parto y durante el puerperio.
Materiales y métodos. Se realizó una revisión de la literatura en Embase, ClinicalKey, ScienceDirect, Access Medicine, Scopus, ProQuest, PubMed y LILACS. Se buscaron estudios sobre trombofilia y tromboprofilaxis en el embarazo publicados entre enero de 2004 y marzo de 2018 en inglés y en español.
Resultados. En la búsqueda inicial se identificaron 126 artículos, de los cuales 52 cumplieron los criterios de inclusión. La mayoría de estudios correspondió a revisiones narrativas (n=15), revisiones sistemáticas (n=8) y guías de práctica clínica (n=6).
Conclusión. Se recomienda el uso de pruebas de tamizaje de estados protrombóticos durante la gestación, el parto y el puerperio, ya que la identificación oportuna de la ETV permite disminuir las tasas de morbimortalidad en esta población mediante la implementación de medidas tromboprofilácticas, sean o no farmacológicas.
Introduction: The risk of developing venous thromboembolism (VTE) in women is 5 to 6 times higher during pregnancy. In addition, this risk can be significantly higher if the patient has a history or family history of hypercoagulate states. VTE is a leading cause of morbidity and mortality in this population, so in order to assess if it is appropriate to use thromboprophylaxis during pregnancy, whether pharmacological or non-pharmacological, it is necessary to timely recognize the clinical risk factors associated with this condition.
Objective: To describe the use, on the one hand, of screening tests for hypercoagulate states and, on the other, of pharmacological and non-pharmacological thromboprophylaxis to prevent the development of VTE during pregnancy, labor and the puerperium
Materials and methods: A literature review was conducted in the Embase, ClinicalKey, ScienceDirect, Acces Medicine, Scopus, ProQuest, PubMed and LILACS databases. The search included studies on thrombophilia and thrombophylaxis during pregnancy published in English or Spanish between January 2004 and March 2018.
Results: After completing the initial search, 126 studies were identified, of which 52 met the inclusion criteria. Most studies were narrative reviews (n=15), systematic reviews (n=8) and clinical practice guidelines (n=6).
Conclusion: The use of screening tests for hypercoagulate states during pregnancy, labor and the puerperium is recommended, since the timely identification of VTE will allow the reduction of morbidity and mortality rates in this population through the implementation of thromboprophylactic measures, whether they are pharmacological or non-pharmacological.
Citas
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Derechos de autor 2020 Revista de la Facultad de Medicina
Esta obra está bajo una licencia Creative Commons Reconocimiento 3.0 Unported.
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