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Perikonzeptionelle Frauenheilkunde pp 157–172Cite as

Die Patientin mit thrombophiler Blutgerinnungsstörung

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Zusammenfassung

Venöse und arterielle Thrombosen sowie thromboembolische Komplikationen wie Lungenarterienembolien tragen weltweit maßgeblich zur Morbidität und Mortalität in der Schwangerschaft und Postpartalphase bei (Chang et al. 2003, Greer 2000, McColl et al. 2000a, Rosfors et al. 2001). Das Risiko venöser thromboembolischer Ereignisse ist bei gesunden Schwangeren im Vergleich zu nicht graviden Frauen gleichen Alters um etwa das 5-fache erhöht, das Risiko arterieller thromboembolischer Ereignisse (apoplektischer Insult, Myokardinfarkt) um das 3- bis 4-fache (James et al. 2005a, 2006a).

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Literatur

  • Andersen BS, Steffensen FH, Sorensen HT, Nielsen GL, Olsen J (1998) The cumulative incidence of venous thromboembolism during pregnancy and puerperium – an 11 year Danish population-based study of 63,300 pregnancies. Acta Obstetricia et Gynecologica Scandinavica 77: 170–173

    Article  PubMed  CAS  Google Scholar 

  • Bates SA, Greer IA, Hirsh J, Ginsberg JS (2004) Use of antithrombotic agents during pregnancy. Chest 126: 627S–644S

    Article  PubMed  CAS  Google Scholar 

  • Bates SM (2007) Management of pregnant women with thrombophilia or a history of venous thromboembolism. Hematology Am Soc Hematol Educ Program 2007: 143–150

    Google Scholar 

  • Bates SM, Greer IA, Middeldorp S, Veenstra DL, Prabulos A-M, Vandvik PO (2012) VTE, thrombophilia and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practic guidelines. Chest 141: e691S–e736S

    Google Scholar 

  • Bates SM, Greer IA, Pabinger I, Sofaer S, Hirsh J (2008) Venous thromboembolism, thrombophilia, antithrombotic therapy, and pregnancy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 133: 844S–886S

    Article  PubMed  CAS  Google Scholar 

  • Bauersachs RM, Dudenhausen J, Faridi A et al. (2007) Risk stratification and heparin prophylaxis to prevent venous thromboembolism in pregnant women. Thromb Haemost 98: 1237–1245

    PubMed  CAS  Google Scholar 

  • Bertina RM, Koeleman BPC, Koster T, Rosendaal FR, Dirven RJ, deRonde H, Vandervelden PA, Reitsma PH (1994) Mutation in Blood-Coagulation Factor-V Associated with Resistance to Activated Protein-C. Nature 369: 64–67

    Article  PubMed  CAS  Google Scholar 

  • Bremme KA (2003) Haemostatic changes in pregnancy. Best Practice & Research: Clinical Haematology 16: 153–168

    Google Scholar 

  • Brenner B, Blumenfeld Z (1997) Thrombophilia and fetal loss. Blood Rev 11: 72–79

    Article  PubMed  CAS  Google Scholar 

  • Brill-Edwards P, Ginsberg JS, Gent M et al. (2000) Safety of withholding heparin in pregnant women with a history of venous thromboembolism. Recurrence of Clot in This Pregnancy Study Group. N Engl J Med 343: 1439–1444

    Article  PubMed  CAS  Google Scholar 

  • Chan WS (2009) The ’ART’ of thrombosis: a review of arterial and venous thrombosis in assisted reproductive technology. Curr Opin Obstet Gynecol 21: 207–218

    Article  PubMed  Google Scholar 

  • Chan WS, Spencer FA, Ginsberg JS (2010) Anatomic distribution of deep vein thrombosis in pregnancy. Canadian Medical Association Journal 182: 657–660

    Article  PubMed  Google Scholar 

  • Chang J, Elam-Evans LD, Berg CJ, Hemdon J, Flowers L, Seed KA, Syverson CJ (2003) Pregnancy-related mortality surveillance-United States, 1991-1999. MMWR Surveill Summ 52: 1–8

    PubMed  Google Scholar 

  • Conard J, Horellou MH, Vandreden P, Lecompte T, Samama M (1990) Thrombosis and Pregnancy in Congenital Deficiencies in At-Iii, Protein-C Or Protein-S - Study of 78 Women. Thromb Haemost 63: 319–320

    PubMed  CAS  Google Scholar 

  • Danilenko-Dixon DR, Heit JA, Silverstein MD, Yawn BP, Petterson TM, Lohse CM, Melton LJI (2001) Risk factors for deep vein thrombosis and pulmonary embolism during pregnancy or post partum: a population-based, case-control study. Am J Obstet Gynecol 184: 104–110

    Article  PubMed  CAS  Google Scholar 

  • De Stefano V, Martinelli I, Rossi E, Battaglioli T, Za T, Mannucci PM, Leone G (2006) The risk of recurrent venous thromboembolism in pregnancy and puerperium without antithrombotic prophylaxis. Br J Haematol 135: 386–391

    Article  PubMed  Google Scholar 

  • Delvigne A, Demoulin A, Smitz J, Donnez J, Koninckx P, Dhont M, Englert Y, Delbeke L, Darcis L, Gordts S (1993) The ovarian hyperstimulation syndrome in in-vitro fertilization: a Belgian multicentric study. I. Clinical and biological features. Hum Reprod 8: 1353–1360

    PubMed  CAS  Google Scholar 

  • DeStefano V, Leone G, Mastrangelo S et al. (1994) Thrombosis During Pregnancy and Surgery in Patients with Congenital Deficiency of Antithrombin-Iii, Protein-C, Protein-S. Thromb Haemost 71: 799–800

    CAS  Google Scholar 

  • Dilley A, Austin H, El-Jamil M et al. (2000) Genetic factors associated with thrombosis in pregnancy in a United States population. Am J Obstet Gynecol 183: 1271–1277

    Article  PubMed  CAS  Google Scholar 

  • Friederich PW, Sanson BJ, Simioni P et al. (1996) Frequency of pregnancy-related venous thromboembolism in anticoagulant factor-deficient women: Implications for prophylaxis. Annals of Internal Medicine 125: 955–960

    Article  PubMed  CAS  Google Scholar 

  • Frosst P, Blom HJ, Milos R et al. (1995) A candidate genetic risk factor for vascular disease: a common mutation in methylenetetrahydrofolate reductase. Nat Genet 10: 111–113

    Article  PubMed  CAS  Google Scholar 

  • Gerhardt A, Scharf RE, Zotz RB (2006) Risk of pregnancy-associated venous thromboembolism in women with a history of prior thrombosis. Blood (ASH Annual Meeting Abstracts) 108: Abstract 1493

    Google Scholar 

  • Gerhardt A, Scharf RE, Beckmann MW, Struve S, Bender HG, Pillny M, Sandmann W, Zotz RB (2000) Prothrombin and factor V mutations in women with a history of thrombosis during pregnancy and the puerperium. N Eng J Med 342: 374–380

    Article  CAS  Google Scholar 

  • Gerhardt A, Scharf RE, Zotz RB (2003) Effect of hemostatic risk factors on the individual probability of thrombosis during pregnancy and the puerperium. Thromb Haemost 90: 77–85

    PubMed  CAS  Google Scholar 

  • Gerhardt A, Zotz RB, Struve S, Scharf RE (2001) Homozygous and combined heterozygous factor V G1691A and prothrombin G20210A mutations as predictors of venous thrombosis during pregnancy. Thromb Haemost (Suppl) Abstract 2982

    Google Scholar 

  • Gherman RB, Goodwin TM, Leung B, Byrne JD, Hethumumi R, Montoro M (1999) Incidence, clinical characteristics, and timing of objectively diagnosed venous thromboembolism during pregnancy. Obstet Gynecol 94: 730–734

    Article  PubMed  CAS  Google Scholar 

  • Greer IA (1999) Thrombosis in pregnancy: maternal and fetal issues. Lancet 353: 1258–1265

    Article  PubMed  CAS  Google Scholar 

  • Greer IA (2000) The challenge of thrombophilia in maternal-fetal medicine. N Eng J Med 342: 424–425

    Article  CAS  Google Scholar 

  • Greer IA, Nelson-Piercy C (2005) Low-molecular-weight heparins for thromboprophylaxis and treatment of venous thromboembolism in pregnancy: a systematic review of safety and efficacy. Blood 106: 401–407

    Article  PubMed  CAS  Google Scholar 

  • Guyatt GH, Norris SL, Schulman S et al. (2012) Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 141: 53S–70S

    Article  PubMed  CAS  Google Scholar 

  • Heit JA, Kobbervig CE, James AH, Petterson TM, Bailey KR, Melton LJI (2005) Trends in the incidence of venous thromboembolism during pregnancy or postpartum: a 30-year population-based study. Ann Intern Med 143: 697–706

    Article  PubMed  Google Scholar 

  • Henriksson P, Westerlund E, Wallen H, Brandt L, Hovatta O, Ekbom A (2013) Incidence of pulmonary and venous thromboembolism in pregnancies after in vitro fertilisation: cross sectional study. BMJ 346: e8632

    Article  PubMed  Google Scholar 

  • Jacobsen AF, Skjeldestad FE, Sandset PM (2008) Incidence and risk patterns of venous thromboembolism in pregnancy and puerperium - a register-based case-control study. Am J Obstet Gynecol 198: 233.e1–233.e7

    Google Scholar 

  • James AH (2009) Venous thromboembolism in pregnancy. Arteriosclerosis Thrombosis and Vascular Biology 29: 326–331

    Google Scholar 

  • James AH, Bushnell CD, Jamison MG, Myers ER (2005a) Incidence and risk factors for stroke in pregnancy and the puerperium. Obstet Gynecol 106: 509–516

    Google Scholar 

  • James AH, Jamison MG, Biswas MS, Brancazio LR, Swamy GK, Myers ER (2006a) Acute myocardial infarction in pregnancy: a United States population-based study. Circulation 113: 1564–1571

    Article  Google Scholar 

  • James AH, Jamison MG, Brancazio LR, Myers ER (2006b) Venous thromboembolism during pregnancy and the postpartum period: incidence, risk factors, and mortality. Am J Obstet Gynecol 194: 1311–1315

    Article  Google Scholar 

  • James AH, Tapson VF, Goldhaber SZ (2005b) Thrombosis during pregnancy and the postpartum period. Am J Obstet Gynecol 193: 216–219

    Article  Google Scholar 

  • Kamphuisen PW, Eikenboom JC, Vos HL, Pablo R, Sturk A, Bertina RM, Rosendaal FR (1999) Increased levels of factor VIII and fibrinogen in patients with venous thrombosis are not caused by acute phase reactions. Thromb Haemost 81: 680–683

    PubMed  CAS  Google Scholar 

  • Khamashta MA, Cuadrado MJ, Mujic F, Taub NA, Hunt BJ, Hughes GRV (1995) The Management of Thrombosis in the Antiphospholipid-Antibody Syndrome. N Eng J Med 332: 993–997

    Article  CAS  Google Scholar 

  • Koster T, Blann AD, Briet E, Vandenbroucke JP, Rosendaal FR (1995) Role of clotting factor VIII in effect of von Willebrand factor on occurrence of deep-vein thrombosis. Lancet 345: 152–155

    Article  PubMed  CAS  Google Scholar 

  • Koster T, Rosendaal FR, Reitsma PH, van der Velden PA, Briet E, Vandenbroucke JP (1994) Factor VII and fibrinogen levels as risk factors for venous thrombosis. A case-control study of plasma levels and DNA polymorphisms–the Leiden Thrombophilia Study (LETS). Thromb Haemost 71: 719–722

    PubMed  CAS  Google Scholar 

  • Kraaijenhagen RA, in’t Anker PS, Koopman MM, Reitsma PH, Prins MH, van den Ende A, Büller HR (2000) High plasma concentration of factor VIIIc is a major risk factor for venous thromboembolism. Thromb Haemost 83: 5–9

    PubMed  CAS  Google Scholar 

  • Kupferminc MJ, Eldor A, Steinman N, Many A, Bar-Am A, Jaffa A, Fait G, Lessing JB (1999) Increased frequency of genetic thrombophilia in women with complications of pregnancy. N Engl J Med 340: 9–13

    Article  PubMed  CAS  Google Scholar 

  • Larsen TB, Sorensen HT, Gislum M, Johnsen SP (2007) Maternal smoking, obesity, and risk of venous thromboembolism during pregnancy and the puerperium: a population-based nested case-control study. Thromb Res 120: 505–509

    Article  PubMed  CAS  Google Scholar 

  • Lepercq J, Conard J, Borel-Derlon A et al. (2001) Venous thromboembolism during pregnancy: a retrospective study of enoxaparin safety in 624 pregnancies. Brit J Ostet Gynaec 108: 1134–1140

    CAS  Google Scholar 

  • Lindqvist P, Dahlback B, Marsal K (1999) Thrombotic risk during pregnancy: a population study. Obstet Gynecol 94: 595–599

    Article  PubMed  CAS  Google Scholar 

  • Long AA, Ginsberg JS, BrillEdwards P et al. (1991) The Relationship of Antiphospholipid Antibodies to Thromboembolic Disease in Systemic Lupus-Erythematosus – A Cross-Sectional Study. Thromb Haemost 66: 520–524

    PubMed  CAS  Google Scholar 

  • Macklon NS, Greer IA (1996) Venous thromboembolic disease in obstetrics and gynaecology: The Scottish experience. Scottish Med J 41: 83–86

    CAS  Google Scholar 

  • Martinelli I, Legnani C, Bucciarelli P, Grandone E, De Stefano V, Mannucci PM (2001) Risk of pregnancy-related venous thrombosis in carriers of severe inherited thrombophilia. Thromb Haemost 86: 800–803

    PubMed  CAS  Google Scholar 

  • McColl MD, Ellison J, Greer IA, Tait RC, Walker ID (2000a) Prevalence of the post-thrombotic syndrome in young women with previous venous thromboembolism. Br J Haematol 108: 272–274

    Article  CAS  Google Scholar 

  • McColl MD, Ellison J, Reid F, Tait RC, Walker ID, Greer IA (2000b) Prothrombin 20210 GA, MTHFR C677T mutations in women with venous thromboembolism associated with pregnancy. Brit J Ostet Gynaec 107: 565–569

    Article  CAS  Google Scholar 

  • McColl MD, Ramsay JE, Tait RC, Walker ID, McCall F, Conkie JA, Carty MJ, Greer IA (1997) Risk factors for pregnancy associated venous thromboembolism. Thromb Haemost 78: 1183–1188

    PubMed  CAS  Google Scholar 

  • McColl MD, Walker ID, Greer IA (1999) The role of inherited thrombophilia in venous thromboembolism associated with pregnancy. Brit J Ostet Gynaec 106: 756–766

    Article  CAS  Google Scholar 

  • Meijers JCM, Tekelenburg WLH, Bouma BN, Bertina RM, Rosendaal FR (2000) High levels of coagulation factor XI as a risk factor for venous thrombosis. N Eng J Med 342: 696–701

    Article  CAS  Google Scholar 

  • Middeldorp S, Libourel EJ, Hamulyak K, van der Meer J, Buller HR (2001) The risk of pregnancy-related venous thromboembolism in women who are homozygous for factor V Leiden. Brit J Haematol 113: 553–555

    Article  CAS  Google Scholar 

  • Miyakis S, Lockshin MD, Atsumi T et al. (2006) International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). Thromb Haemost 4: 295–306

    Article  CAS  Google Scholar 

  • O’Donnell J, Mumford AD, Manning RA, Laffan M (2000) Elevation of FVIII:C in venous thromboembolism is persistent and independent of the acute phase response. Thromb Haemost 83: 10–13

    PubMed  Google Scholar 

  • O’Donnell J, Tuddenham EG, Manning R, Kemball-Cook G, Johnson D, Laffan M (1997) High prevalence of elevated factor VIII levels in patients referred for thrombophilia screening: role of increased synthesis and relationship to the acute phase reaction. Thromb Haemost 77: 825–828

    PubMed  Google Scholar 

  • Pabinger I, Grafenhofer H, Kaider A, Kyrle PA, Quehenberger P, Mannhalter C, Lechner K (2005) Risk of pregnancy-associated recurrent venous thromboembolism in women with a history of venous thrombosis. Thromb Haemost 3: 949–954

    Article  CAS  Google Scholar 

  • Pabinger I, Grafenhofer H, Kyrle PA, Quehenberger P, Mannhalter C, Lechner K, Kaider A (2002) Temporary increase in the risk for recurrence during pregnancy in women with a history of venous thromboembolism. Blood 100: 1060–1062

    Article  PubMed  CAS  Google Scholar 

  • Pabinger I, Nemes L, Rintelen C et al. (2000) Pregnancy-associated risk for venous thromboembolism and pregnancy outcome in women homozygous for factor V Leiden. Hematol J 1: 37–41

    Article  PubMed  CAS  Google Scholar 

  • Pabinger I, Schneider B (1996) Thrombotic risk in hereditary antithrombin III, protein C, or protein S deficiency - A cooperative, retrospective study. Arteriosclerosis Thrombosis and Vascular Biology 16: 742–748

    Google Scholar 

  • Poort SR, Rosendaal FR, Reitsma PH, Bertina RM (1996) A common genetic variation in the 3’-untranslated region of the prothrombin gene is associated with elevated plasma prothrombin levels and an increase in venous thrombosis. Blood 88: 3698–3703

    Google Scholar 

  • Ray JG, Chan WS (1999) Deep vein thrombosis during pregnancy and the puerperium: a meta-analysis of the period of risk and the leg of presentation. Obstetrical & Gynecological Survey 54: 265–271

    Google Scholar 

  • Robertson L, Wu O, Langhorne P, Twaddle S, Clark P, Lowe GDO, Walker ID, Greaves M, Brenkel I, Regan L, Greer IA (2006) Thrombophilia in pregnancy: a systematic review. Brit J Haematol 132: 171–196

    Article  CAS  Google Scholar 

  • Rosendaal FR (1999) Venous thrombosis: a multicausal disease. Lancet 353: 1453–1457

    Article  Google Scholar 

  • Rosfors S, Noren A, Hjertberg R, Persson L, Lillthors K, Torngren S (2001) A 16-year haemodynamic follow-up of women with pregnancy-related medically treated iliofemoral deep venous thrombosis. Eur J Vasc Endovasc Surg 22: 448–455

    Article  PubMed  CAS  Google Scholar 

  • Seligsohn U, Lubetsky A (2001) Medical progress: Genetic susceptibility to venous thrombosis. N Eng J Med 344: 1222–1231

    Article  CAS  Google Scholar 

  • Sibai BM (1999) Thrombophilias and adverse outcomes of pregnancy – what should a clinician do? N Engl J Med 340: 50–52

    Article  PubMed  CAS  Google Scholar 

  • Simpson EL, Lawrenson RA, Nightingale AL, Farmer RD (2001) Venous thromboembolism in pregnancy and the puerperium: incidence and additional risk factors from a London perinatal database. BJOG 108: 56–60

    PubMed  CAS  Google Scholar 

  • Vlot AJ, Koppelman SJ, Bouma BN, Sixma JJ (1998) Factor VIII and von Willebrand factor. Thromb Haemost 79: 456–465

    PubMed  CAS  Google Scholar 

  • Ware JA, Coller BS (1995) Platelet morphology, biochemistry, and function. In: Beutler E, Lichtman MA, Coller S, Kipps TJ (eds.) Williams Hematology, 5th ed. New York: McGrawhill, p. 1161–1201

    Google Scholar 

  • Zotz RB, Gerhardt A, Scharf RE (2003a) Inherited Thrombophilia and gestational venous thromboembolism. Best Pract Clin Haematol 16: 243–259

    Google Scholar 

  • Zotz RB, Gerhardt A, Scharf RE (2003b) Prediction, prevention, and treatment of venous thromboembolic disease in pregnancy. Seminars in Thrombosis and Hemostasis 29: 143–153

    Google Scholar 

  • Zotz RB, Gerhardt A, Scharf RE (2006) Venöse Thrombose in der Schwangerschaft. Hämostaseologie 26: 63–71

    Google Scholar 

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Authors and Affiliations

  1. Centrum für Blutgerinnungsstörung und Transfusionsmedizin, Immermannstr. 65a, 40210, Düsseldorf, Deutschland

    Rainer B. Zotz

  2. Blutgerinnung Ulm, Friedenstrasse 1, 89073, Ulm, Deutschland

    A. Gerhardt

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  1. Rainer B. Zotz
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  2. A. Gerhardt
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  1. Grevenbroicher Endokrinologikum IVF-Zentrum, green-ivf, Grevenbroich, Germany

    Christian Gnoth

  2. Klinik u. Polikl. f. für Gyn. u. Gebh., Universitätsklinik Köln, Köln, Germany

    Peter Mallmann

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Zotz, R., Gerhardt, A. (2014). Die Patientin mit thrombophiler Blutgerinnungsstörung. In: Gnoth, C., Mallmann, P. (eds) Perikonzeptionelle Frauenheilkunde. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-38023-5_16

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