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Thromboembolic problems in pregnancy

Published online by Cambridge University Press:  10 October 2008

IA Greer*
Affiliation:
University of Edinburgh, Centre for Reproductive Biology, Edinburgh, UK
*
Dr. IA Greer, Lecturer in Obstetrics and Gynaecology, University of Edinburgh, Centre for Reproductive Biology, 37 Chalmers Street, Edinburgh EH3 9EW, UK.

Extract

Pregnancy appears to increase the risk of thromboembolism sixfold, but there are wide variations in the reported incidence of thromboembolic complications during pregnancy. This is due to diagnostic difficulties and the inculsion of various clinical entities within the disease classification. However, there are reliable data on the incidence of fatal pulmonary thromboembolism (PTE) due to the detailed and thorough reports of the confidential enquiries into Maternal Deaths in England and Wales.

Type
Articles
Copyright
Copyright © Cambridge University Press 1989

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References

1Royal College of General Practitioners. Oral contraception and thromboembolic disease. Journal of the Royal College of General Practitioners 1967; 13: 267–79.Google Scholar
2Coon, W, Willis, P, Keller, J.Venous thromboembolism and other venous diseases in the Tecumseh community health study. Circulation 1973; 48: 839.CrossRefGoogle ScholarPubMed
3Aaro, KA, Juergens, JL.Thrombophlebitis associated with pregnancy. Am J Obstet Gynecol 1971; 109: 1128–33.CrossRefGoogle ScholarPubMed
4Hiilesmaa, V.Occurrence and anticoagulant treatment in gravidas, parturients and gynaecological patients. Acta Obstet Gynaecol Scand. 1960; suppl 2.Google Scholar
5Daniel, DG, Campbell, H, Turnbull, AC.Puerperal thromboembolism and suppression of lactation. Lancet 1967; 2: 287–89.CrossRefGoogle ScholarPubMed
6Husni, E, Pena, L, Lenhert, E.Thrombophlebitis in pregnancy. Am J Obstet Gynecol 1967; 97: 901.CrossRefGoogle ScholarPubMed
7Flessa, HC, Glueck, HI, Dritschilo, A.Thromboembolic disorders in pregnancy. Clin Obstet Gynecol 1974; 17: 195235.CrossRefGoogle ScholarPubMed
8Genton, E, Turpie, AGG.Venous thromboembolism associated with gynecologic surgery. Clin Obstet Gynecol 1980; 23: 209–41.CrossRefGoogle ScholarPubMed
9Friend, JR, Kakkar, VV.The diagnosis of deep venous thrombosis in the puerperium. J Obstet Gynaecol Br Commonwlth 1970; 77: 820.CrossRefGoogle ScholarPubMed
10Bergqvist, A, Bergqvist, D, Hallbrook, T.Deep vein thrombosis during pregnancy. Acta Obstet Gynaecol Scand 1983; 62: 443–48.CrossRefGoogle ScholarPubMed
11Bergqvist, A, Bergqvist, D, Hallbrook, T.Acute deep venous thrombosis after caesarean section. Acta Obstet Gynaecol Scand 1979; 58: 473–76.CrossRefGoogle Scholar
12Villa Santa, U.Thromboembolic disease in pregnancy. Am J Obstet Gynecol 1965; 93: 142.CrossRefGoogle Scholar
13Weiner, CP.Diagnosis and management of thromboembolic disease during pregnancy. Clin Obstet Gynecol 1985; 28: 107–17.CrossRefGoogle ScholarPubMed
14Letsky, E, de Swiet, M.Thromboembolism in pregnancy and its management. Br J Haematol 1984; 57: 543–52.CrossRefGoogle ScholarPubMed
15Virchow, R.Die verstopfung den lungen arterie und ihre folgen. Bectt Exp Pathol Physiol 1846; 2: 1.Google Scholar
16Gibbs, NM.Venous thrombosis of the lower limbs with particular reference to bed rest. Br J Surg 1957; 45: 209.CrossRefGoogle ScholarPubMed
17Thorburn, J, Louden, J, Vallance, R.Spinal and general anaesthesia in total hip replacement: frequency of deep venous thrombosis. Br J Anaesth 1980; 52: 1117–21.CrossRefGoogle Scholar
18Lawson, DH, Parker, JLW.Deaths from severe megaloblastic anaemia in hospitalised patients. Scand J Haematol 1976; 17: 347–52.CrossRefGoogle ScholarPubMed
19Pearson, TC, Weatherley-Main, G.Vascular occlusive episodes and venous haematocrit in primary proliferative polycythaemia. Lancet 1978; 2: 1219–22.CrossRefGoogle ScholarPubMed
20Lowe, GDO, Campbell, AF, Meek, DR, Forbes, CD, Prentice, CRM, Cummings, S.Subcutaneous ancrod in prevention of deep venous thrombosis after operation for fractured neck of femur. Lancet 1978; 1: 784–86.Google Scholar
21Moncada, S, Herman, AG, Higgs, EA, Vane, JR.Differential formation of prostacyclin by layers of the arterial wall. An explanation for the antithrombotic properties of the vascular endothelium. Thromb Res 1977; 11: 322–24.CrossRefGoogle Scholar
22Willner, GD, Nossel, HL, Leroy, EC.Activation of Hageman factor by collagen. J Clin Invest 1968; 47: 2616.Google Scholar
23Willner, GD, Nossel, HL, Leroy, EC.Activation of Hageman factor by collagen. J Clin Invest 1968; 47: 2608–15.CrossRefGoogle Scholar
24Coller, BS. Disorders of platelets. In: Ratnoff, OD, Forbes, CD eds, Disorders of haemostasis, New York: Grune & Stratton, 1984: 73176.Google Scholar
25Saito, H. Normal haemostatic mechanismss. In: Ratnoff, OD, Forbes, CD eds, Disorders of haemostasis, New York: Grune & Stratton, 1984: 2342.Google Scholar
26Wessler, S, Reiner, L, Freiman, DG, Reiner, SM, Lertzman, M.Serum induced thrombosis. Circulation 1959; 20: 864–74.CrossRefGoogle ScholarPubMed
27Egeberg, O.Inherited anti-thrombin deficiency causing thrombophilia. Thrombosis Diath Haemorrh 1965; 13: 516–30.Google Scholar
28Verstraete, M, Vermylen, J.Thrombosis. Oxford: Pergamon Press 1984: 154.Google Scholar
29Horellou, MH, Conrad, J, Bertina, RM, Samama, M.Congenital protein C deficiency and thrombotic disease in 9 French families. Br Med J 1984; 289: 1285–87.CrossRefGoogle ScholarPubMed
30Hathaway, WE, Bonnar, J.Haemostatic disorders of the pregnant woman and newborn infant. New York: Elsevier, 1987.Google Scholar
31Stirling, Y, Woolf, L, North, WRS, Seghatchian, MJ, Meade, TW.Haemostasis in normal pregnancy. Thromb Haemostas 1984; 52: 176–82.Google ScholarPubMed
32Mannucci, PM, Vigano, S, Bottasso, B et al. Protein C antigen during pregnancy delivery and puerperium. Thromb Haemostas 1984; 52: 217.Google ScholarPubMed
33Malm, J, Laurell, M, Dahlback, B et al. Changes in the plasma levels of Vitamin K-dependent proteins C and S and of C4b-binding protein during pregnancy and oral contraception. Br J Haematol 1988; 68(4): 437–43.CrossRefGoogle Scholar
34Comp, PC, Thurneau, GR, Welsh, J, Esmon, CT.Functional and immunologic protein S levels are decreased during pregnancy. Blood 1986; 68: 881–85.CrossRefGoogle ScholarPubMed
35Wiman, B, Csemiczky, G, Marsk, L, Robbe, H.The fast inhibitor of tissue plasminogen activator in plasma during pregnancy. Thromb Haemostas 1984; 52: 124–26.Google ScholarPubMed
36Wiman, B, Chmielewska, J.A novel fast inhibitor to tissue plasminogen activator in plasma, which may be of great pathological significance. Scand J Clin Lab Invest 1985; 45(suppl 177yes): 4347.Google Scholar
37Aaro, KA, Juergens, JL.Thrombophlebitis and pulmonary embolism as a complication of pregnancy. Med Clin North America 1974; 58: 829.CrossRefGoogle Scholar
38Wright, HP, Osborn, SB, Edmonds, DG.Changes in the rate of flow of venous blood in the leg during pregnancy measured with radioactive sodium. Surg Gynecol Obstet 1959; 90: 481–85.Google Scholar
39Badaracco, MA, Vessey, M.Recurrence of venous thromboembolism disease and use of oral contraceptives. Br Med J 1974; 1: 215–17.CrossRefGoogle ScholarPubMed
40Howell, R, Fidler, J, Letsky, E, de Swiet, M.The risks of antenatal subcutaneous heparin prophylaxis; a controlled trial. Br J Obstet Gynaecol 1983; 90: 1124–28.CrossRefGoogle ScholarPubMed
41de Swiet, M, Floyd, E, Letsky, E.Low risk of recurrent thromboembolism in pregnancy. Br J Hosp Med 1987; 38: 264.Google ScholarPubMed
42Thomas, AN, Pattison, C, Serjeant, GR.Causes of death in sickle-cell disease in Jamaica. Br Med J 1982; 285: 633–35.CrossRefGoogle ScholarPubMed
43Van Dinh, T, Boor, PJ, Gazra, JR.Massive pulmonary embolism following delivery of a patient with sickle cell trait. Am J Obstet Gynecol 1982; 143: 722–24.CrossRefGoogle ScholarPubMed
44Jick, H, Slone, D, Westerholm, B et al. Venous thromboembolic disease and ABO blood type. A co-operative study. Lancet 1969; 1: 539–42.CrossRefGoogle Scholar
45Ramsey, LE.Impact of venography on the diagnosis and management of deep venous thrombosis. Br Med J 1983; 286: 698–99.CrossRefGoogle Scholar
46Prentice, AG, Lowe, GDO, Forbes, CD.Diagnosis and treatment of venous thromboembolism by consultants in Scotland. Br Med J 1982; 285: 630–32.CrossRefGoogle ScholarPubMed
47Belch, JJF, McMillan, NC, Fogelman, I, Capell, H, Forbes, CD.Combined phlebography and arthrography in patients with painful swollen calf. Br Med J 1981; 282: 949.CrossRefGoogle ScholarPubMed
48Browse, N.Diagnosis of deep venous thrombosis. Br Med Bull 1978; 34: 163–67.CrossRefGoogle Scholar
49Bettman, MA, Paulin, S.Leg phlebography: The incidence, nature and modification of undesirable side effects. Radiology 1977; 122: 101104.CrossRefGoogle Scholar
50Cranley, JJ. Venous thrombosis secondary to phlebography. In: Vascular surgery, volume 2, Hagerstown, Maryland: Harper and Row, 1975: 7071.Google Scholar
51Albrechtsson, V, Olsson, CG.Thrombosis after phlebography: a comparison of two contrast media. Cardiovasc Radiol 1979; 2: 918.CrossRefGoogle ScholarPubMed
52Laros, RK, Alger, LS.Thromboembolism in pregnancy. Clin Obstet Gynecol 1979; 22: 871–73.CrossRefGoogle Scholar
53Hull, R, van Aken, WG, Hirsh, J et al. Impedence plethysmography using the occlusive cuff technique in the diagnosis of venous thrombosis. Circulation 1976; 53: 696700.CrossRefGoogle ScholarPubMed
54Clarke-Pearson, DL, Jolovsek, FR.Alterations of occlusive cuff impedence plethysmography results in obstetric patients. Surgery 1981; 89: 594–98.Google Scholar
55Hirsh, J, Genton, E, Hull, R.Venous thromboembolism. New York: Grune & Stratton, 1981.Google Scholar
56Sulliven, ED, Peter, DJ, Cranley, JJ.Real time B-mode venous ultrasound. J Vasc Surg 1984; 1: 465–71.CrossRefGoogle Scholar
57Aitken, AGF, Godden, DJ.Real time diagnosis of deep venous thrombosis: a comparison with venography. Clinical Radiology 1987; 38: 309–13.CrossRefGoogle ScholarPubMed
58Effeney, DJ, Friedman, MB. Gooding, GAW.Ileofemoral venous thrombosis: real time ultrasound diagnosis, normal criteria and clinical application. Radiology 1984; 150: 787–92.CrossRefGoogle Scholar
59Coelho, JC, Sigel, B, Ryva, JC, Machi, J, Renigers, SA.B-mode sonography of blood clots. J Clin Ultrasound 1982; 10: 323–27.CrossRefGoogle ScholarPubMed
60Cronan, JJ, Dorfman, GS, Scola, FM, Schepps, B, Alexander, J.Deep venous thrombosis: US assessment using vein compression. Radiology 1987; 162: 191–94.CrossRefGoogle ScholarPubMed
61Ludlam, CA, Moore, S, Bolton, AE, Cash, JD.New rapid method for diagnosis of deep venous thrombosis. Lancet 1975; 2: 259–60.CrossRefGoogle ScholarPubMed
62Wenger, NK, Stein, PD, Willis, PW.Massive acute pulmonary embolism. The deceivingly nonspecific manifestations. JAMA 1972; 220: 843–44.CrossRefGoogle ScholarPubMed
63Windebank, WJ.Diagnosing pulmonary thromboembolism. Br Med J 1987; 294: 1369–70.CrossRefGoogle ScholarPubMed
64Robin, ED.Overdiagnosis and over-treatment of pulmonary embolism: The emperor may have no clothes. Ann Intern Med 1977; 87: 775–81.CrossRefGoogle ScholarPubMed
65McBride, K, La Morte, WW, Menzoian, JO.Can ventilation-perfusion scans accurately diagnose pulmonary embolism? Arch Surg 1986; 121: 754–57.CrossRefGoogle Scholar
66Hull, RD, Raskob, GE, Hirsh, J.The diagnosis of clinically suspected pulmonary embolism. Chest 1986; 89(suppl): 417–25.Google ScholarPubMed
67Hirsh, J.Mechanism of action and monitoring of anticoagulants. Sem Thromb Haemostas 1986; 12: 111.CrossRefGoogle ScholarPubMed
68Salzman, EW, Rosenberg, RD, Smith, MH, Linden, JN, Favreau, L.Effect of heparin and heparin fractions on platelet aggregation. J Clin Invest 1980; 65: 5473.CrossRefGoogle ScholarPubMed
69de Prost, D.Heparin fractions and analogues. Trends in Pharmacological Sciences 1986; 496500.CrossRefGoogle Scholar
70Flessa, HC, Kapstrom, AB, Glueck, HI, Will, JJ.Placental transport of heparin. Am J Obstet Gynecol 1965; 93: 570–73.CrossRefGoogle ScholarPubMed
71Forestier, F, Daffos, F, Capella-Pavlovsky, M.Low molecular weight heparin (PK 10169) does not cross the placenta during the second trimester of pregnancy: Study by direct fetal blood sampling under ultrasound. Thromb Res 1984; 34: 557–60.CrossRefGoogle Scholar
72Andrew, M, Boneu, B, Cade, J et al. Placental transport of low molecular weight heparin in the pregnant sheep. Br J Haematol 1985; 59: 103108.CrossRefGoogle ScholarPubMed
73Griffith, GC, Nichols, G, Asher, JD, Flanagan, B.Heparin osteoporosis. JAMA 1965; 193: 8588.CrossRefGoogle ScholarPubMed
74Wise, PH, Hall, AJ.Heparin induced osteopenia in pregnancy. Br Med J 1980; 281: 110–11.CrossRefGoogle ScholarPubMed
75Squires, JW, Pinch, LW.Heparin induced spinal fractures. JAMA 1979; 241: 2417–18.CrossRefGoogle ScholarPubMed
76de Swiet, M, Dorrington, Ward P, Fidler, J et al. Prolonged heparin therapy in pregnancy causes bone demineralisation (heparin-induced osteopenia). Br J Obstet Gynaecol 1983; 90: 1129–34.CrossRefGoogle Scholar
77Aarskog, A, Aksnes, L, Lehmann, V.Low 1, 25-Dihydroxyvitamin D in heparin-induced osteopenia. Lancet 1980; 2: 650–51.CrossRefGoogle ScholarPubMed
78King, DJ, Kelton, JG.Heparin associated thrombocytopenia. Ann Intern Med 1984; 100: 535–40.CrossRefGoogle ScholarPubMed
79Chong, BH, Pitney, WR, Castaldi, PA.Heparin-induced thrombocytopenia: Association of thrombotic complications with heparin dependent IgG antibody that induces thromboxane synthesis and platelet aggregation. Lancet 1982; 2: 1246–49.CrossRefGoogle ScholarPubMed
80Meytes, D, Ayalou, H, Virag, I, Weisbort, Y, Zakut, H.Heparin induced thrombocytopenia and recurrent thrombosis in pregnancy. A case report. J Reprod Med 1986; 31: 993–96.Google ScholarPubMed
81Harenberg, J, Leber, G, Zimmerman, R, Schmidt, W.Thromboemboleprophylaxe mit nieder molekularem Heparin in der Schwangerschaft. Gebertshilfe Frauenheilkd 1987; 47: 1518.CrossRefGoogle Scholar
82Henny, CP, ten Cate, H. ten Cate, JW, Prummel, MF, Peters, M, Buller, HR.Thrombosis prophylaxis in an ATIII deficient pregnant woman: application of low molecular weight heparinoid. Thromb Haemostas 1986; 55: 301.Google Scholar
83Hall, JG, Pauli, RM, Wilson, KM.Maternal and fetal sequelae of anticoagulation during pregnancy. Am J Med 1980; 68: 122–40.CrossRefGoogle ScholarPubMed
84Orme, M, L'E Lewis, PJ, de Swiet, M et al. May mothers given warfarin breast-feed their infants? Br Med J 1977; 1: 1564–65.CrossRefGoogle ScholarPubMed
85Iturbe-Alessio, I, del Carmen Fonseca, M, Mutchinik, O, Santos, MA, Zajarias, A, Salazar, E.Risks of anticoagulant therapy in pregnant women with artificial heart valves. New Engl J Med 1986; 315: 1390–93.CrossRefGoogle ScholarPubMed
86Stevenson, RE, Burton, M, Ferlauto, GJ, Taylor, HA.Hazards of oral anticoagulants during pregnancy. JAMA 1980; 243: 1549–51.CrossRefGoogle ScholarPubMed
87Cox, DR, Martin, L, Hall, BD.Asplenia syndrome after fetal exposure to warfarin. Lancet 1977; 2: 1134.CrossRefGoogle ScholarPubMed
88Chong, MKB, Harvey, D, de Swiet, M.Follow up of children whose mothers were treated with warfarin during pregnancy. Br J Obstet Gynaecol 1984; 91: 1070–73.CrossRefGoogle ScholarPubMed
89Chen, WCC, Chan, CS, Lee, PK, Wang, RYC, Wong, VCW.Pregnancy in patients with prosthetic heart valves: an experience with 45 pregnancies. Quart J Med 1982; LI: 358–65.Google Scholar
90de Swiet, M, Letsky, E, Mellows, H. Drug treatment and prophylaxis of thromboembolism in pregnancy. In: Lewis, PJ ed, Therapeutic problems in pregnancy, Lancaster: MTP, 1977.Google Scholar
91Salazar, E, Zajarias, A, Gutierrez, N, Iturbe, I.The problem of cardiac valve prostheses anticoagulants and pregnancy. Circulation 1984; 70(Suppl 1yes): I-169I-177.Google ScholarPubMed
92Lutz, DJ, Noller, KL, Spittell, JA, Danielson, GK, Fish, CR.Pregnancy and its complications following cardiac valve prostheses. Am J Obstet Gynecol 1978; 131: 460–68.CrossRefGoogle ScholarPubMed
93Larrea, JL, Nunez, L, Reque, JA, Gil Aguado, M, Matarros, R, Minguez, JA.Pregnancy and mechanical valve prostheses: a high risk situation for the mother and the fetus. Ann Thorac Surg 1983; 36: 459–63.CrossRefGoogle ScholarPubMed
94Salzman, EW, Deykin, D, Shapiro, RM, Rosenberg, R.Management of heparin therapy. N Eng J Med 1975; 292: 1046–50.CrossRefGoogle ScholarPubMed
95Glazier, RL, Crowel, EB.Randomised prospective trial of continuous versus intermittent heparin therapy. JAMA 1976; 236: 1365–67.CrossRefGoogle Scholar
96Hull, RD, Raskob, GE, Hirsh, J et al. Continuous intravenous heparin compared with intermittent subcutaneous heparin in the initial treatment of proximal-vein thrombosis. New Eng J Med 1986; 315: 1109–14.CrossRefGoogle ScholarPubMed
97Andersson, G, Fagrell, B, Holmgren, K et al. Subcutaneous administration of heparin. A randomized comparison with intravenous administration of heparin to patients with deep-vein thrombosis. Thromb Res 1982; 27: 631–39.CrossRefGoogle ScholarPubMed
98Bentley, PG, Kakkar, VV, Scully, MF et al. An objective study of alternative methods of heparin administration. Thromb Res 1980; 18: 177–87.CrossRefGoogle ScholarPubMed
99Zucker, S, Cathey, MH.Control of heparin therapy. J Lab Clin Med 1969; 73: 320–26.Google ScholarPubMed
100Basu, D, Gallus, A, Hirsh, J, Cade, JF.A prospective study of the value of monitoring heparin treatment with the activated thromboplastin time. N Eng J Med 1972; 287: 324–27.CrossRefGoogle Scholar
101Pitney, Wr, Pettit, JE, Armstrong, L.Control of heparin therapy. Br Med J 1970; 4: 139–41.CrossRefGoogle ScholarPubMed
102Whitfield, LR, Lele, AS, Levy, G.Effect of pregnancy on the relationship between concentration and anticoagulant action of heparin. Clin Pharmacol Ther 1983; 34: 2328.CrossRefGoogle ScholarPubMed
103Bonnar, J. Long-term self-administered heparin therapy for prevention of thromboembolic complications in pregnancy. In: Kakkar, VV, Thomas, DP eds, Heparin: chemistry and clinical usage. London: Academic Press, 1976; 247–60.Google Scholar
104de Swiet, M.Thromboembolism. Clinics in Haematology 1985; 14: 643–61.CrossRefGoogle ScholarPubMed
105Chiu, HM, Hirsh, J, Yung, WL, Regoeczi, E, Gent, M.Relationship between the anticoagulant and antithrombotic effects of heparin in experimental venous thrombosis. Blood 1977; 49: 171–84.CrossRefGoogle ScholarPubMed
106Denson, KWE, Bonnar, J.The measurement of heparin: a method based on the potentiation of anti-factor Xa. Thrombosis et Diathesis Haemorrhagica 1973; 30: 471–79.Google ScholarPubMed
107Crawford, JS.Principles and practice of obstetric anaesthesia. Fourth edition. Oxford: Blackwell Publications, 1978: 182–83.Google Scholar
108Bergqvist, D.Post-operative thromboembolism. New York: Springer Verlag, 1983: 106107.CrossRefGoogle Scholar
109Hill, NCW, Hill, JG, Sargent, JM, Taylor, CG, Bush, PV.Effect of low dose heparin on blood loss at caesarean section. Br Med J 1988; 296: 1505–506.CrossRefGoogle ScholarPubMed
110Spowart, K, Greer, IA, McLaren, M, Lloyd, J, Bullingham, R, Forbes, CD.Haemostatic effects of ketorolac with and without heparin. Thromb Haemostas 1988; 60: 382–86.Google ScholarPubMed
111Ludwig, H.Results of streptokinase therapy in deep vein thrombosis during pregnancy. Postgrad Med J 1973; Suppl 5yes(49): 6567.Google Scholar
112Hall, RJ, Young, C, Sutton, GC, Campbell, S.Treatment of acute massive pulmonary embolism by streptokinase during labour and delivery. Br Med J 1972; 4: 647–49.CrossRefGoogle ScholarPubMed
113McTaggart, DR, Ingram, TG.Massive pulmonary embolism during pregnancy treated with streptokinase. Med J Australia 1977; 1: 1820.CrossRefGoogle ScholarPubMed
114Collen, D. mechanism and clinical aspects. In: Bowie, EJW, Sharp, AA eds, Haemostasis and thrombosis. London: Butterworths, 1985: 237–58.Google Scholar
115Jones, TK, Barnes, RW, Greenfield, LJ.Greenfield vena caval filter: rationale and current indications. Ann Thorac Surg 1986; 42 (Suppl 1yes): 4855.CrossRefGoogle ScholarPubMed
116Donaldson, MC, Wirthlin, LS, Donaldson, GA.Thirty year experience with surgical interruption of the inferior vena cava for prevention of pulmonary embolism. Ann Surg 1980; 191: 367–72.CrossRefGoogle ScholarPubMed
117Hux, CH, Wapner, RJ, Clayen, B, Ratton, P, Jarrell, B, Greenfield, L.Use of the Greenfield filter for thromboembolic disease in pregnancy. Am J Obstet Gynecol 1986; 155: 734–37.CrossRefGoogle ScholarPubMed
118Lao, TT, de Swiet, M, Letsky, E, Walters, BNJ.Prophylaxis of thromboembolism in pregnancy: an alternative. Br J Obstet Gynaecol 1985; 92: 202206.CrossRefGoogle ScholarPubMed
119Rutherford, SE, Phelan, JP.Thromboembolic disease in pregnancy. Clinics in Perinatology 1986; 13: 719–39.CrossRefGoogle ScholarPubMed
120Chesebro, JH, Adams, PC, Fuster, V.Antithrombotic therapy in patients with valvular heart disease and prosthetic heart valves. J Am Coll Cardiol 1986; 8: 4156B.CrossRefGoogle ScholarPubMed
121Mok, CK, Boey, J, Wang, R et al. Warfarin versus dipyriamole-aspirin + pentoxifylline-aspirin for the prevention of prosthetic heart valve thromboembolism - a prospective randomized clinical trial. Circulation 1985; 72: 1059–63.CrossRefGoogle ScholarPubMed
122Wang, RYC, Lee, PK, Chow, JSF, Chen, WWC.Efficacy of low dose, subcutaneously administered heparin in treatment of pregnant women with artificial heart valves. Med J Aust 1983; 2: 126–28.CrossRefGoogle ScholarPubMed
123Lee, PR, Wang, RYC, Chow, JSF, Cheung, KL, Wong, YCW, Chan, TR.Combined use of warfarin and adjusted sodium heparin during pregnancy in patients with an artificial heart valve. J Am Coll Cardiol 1986; 8: 221–24.CrossRefGoogle ScholarPubMed
124Sas, G, Blasko, G, Banhegyi, D, Jako, J, Palos, LA.Abnormal antithrombin III as a cause of familial thrombophilia. Thromb Diath Haemorr 1974; 32: 105–15.Google ScholarPubMed
125Winter, JH, Bennett, B, Watt, JL et al. Confirmation of linkage between antithrombin III and Duffy blood group and assignment of ATIII to Iq22/lq25. Ann Hum Gen 1982; 46: 2934.CrossRefGoogle Scholar
126Odegard, OR, Abildgaard, U.Anti-thrombin III; critical review of assay methods. Haemostasis 1978; 7: 127–34.Google Scholar
127Brandt, P, Stenbjerg, S.Subcutaneous heparin for thrombosis in pregnant women with hereditary antithrombin deficiency. Lancet 1979; 1: 100–01.CrossRefGoogle ScholarPubMed
128Winter, JH, Fenech, A, Ridley, W et al. Familial antithrombin III deficiency. Quart J Med 1982; 51: 373–95.Google ScholarPubMed
129Hellgren, M, Tengborn, L, Abildgaard, V.Pregnancy in women with congenital ATIII deficiency. Experience of treatment with heparin antithrombin. Gynaecol Obstet Invest 1982; 14: 127–41.CrossRefGoogle Scholar
130Samson, D, Stirling, Y, Woolf, L, Howarth, D, Seghatchian, MJ, de Chazal, R.Management of planned pregnancy in a patient with congenital antithrombin III deficiency. Br J Haematol 1984; 56: 243–49.CrossRefGoogle Scholar
131Griffin, JH, Evatt, B, Zimmerman, TS, Kleiss, AJ, Wideman, C.Deficiency of protein C in congenital thrombotic disease. J Clin Invest 1981; 68: 1370–75.CrossRefGoogle ScholarPubMed
132Broekmans, AW, Veltkampm, JJ, Bertina, RM.Congenital protein C deficiency and venous thromboembolism. N Eng J Med 1983; 309: 340–44.CrossRefGoogle ScholarPubMed
133Miletich, J, Sherman, L, Broze, G.Absence of thrombosis in subjects with heterozygous protein C deficiency. N Eng J Med 1987; 317: 991–96.CrossRefGoogle ScholarPubMed
134Comp, PC, Nixon, RR, Cooper, MR, Esmon, CT.Familial protein S deficiency is associated with recurrent thrombosis. J Clin Invest 1984; 74: 2082–88.CrossRefGoogle ScholarPubMed
135Conard, J, Horellou, MH, Van Dreden, P, Samama, M.Pregnancy and congenital deficiency in anti-thrombin III or protein C. Abstracts of Xlth International Congress on Thrombosis and Haemostasis 1987: 39.Google Scholar
136Gonzalez, R, Alberca, I, Sala, N, Vicente, V.Protein C deficiency-response to danazol and DDAVP. Thromb Haemostas 1985; 53: 320–22.Google ScholarPubMed
137Carter, CJ, Bellem, PJ.Management of protein C deficiency in pregnancy. Fibrinolysis 1988; Suppl 1: 161.CrossRefGoogle Scholar
138Broekmans, AW, Bertina, RM, Reinalda-Poot, J et al. Hereditary protein S deficiency and venous thrombo-embolism. Thromb Haemostas 1985; 53: 273–77.Google ScholarPubMed
139Michiels, JJ, Stibbe, J, Bertina, R, Broekman, A.Effectiveness of long term oral anticoagulant therapy in preventing venous thrombosis in hereditary protein S deficiency. Br Med J 1987; 295: 641–43.CrossRefGoogle ScholarPubMed
140Conley, CL, Hartman, RC.A haemorrhagic disorder caused by circulating anticoagulant in patients with disseminated lupus erythematosus. J Clin Invest 1952; 31: 651–52.Google Scholar
141Bowie, EJW, Thompson, JH, Pascuzzi, CA, Owen, CA.Thrombosis in systemic lupus erythematosis despite circulating anticoagulants. J Lab Clin Med 1963; 62: 416–30.Google ScholarPubMed
142Mueh, JR, Herbst, KD, Rapaport, SI.Thrombosis in patients with the lupus anticoagulant. Ann Intern Med 1980; 92: 156–59.CrossRefGoogle ScholarPubMed
143Carreras, LO, Vermylen, J, Spitz, B, Van Assche, A.Lupus anticoagulant and inhibition of prostacyclin formation in patients with recurrent abortion, intra-uterine growth retardation and intra-uterine death. Br J Obstet Gynaecol 1981; 88: 890–94.CrossRefGoogle Scholar
144Walker, TS, Triplett, DA, Javed, N, Musgrave, K.Evaluation of lupus anticoagulants. Thromb Res 1988; 51: 267–81.CrossRefGoogle ScholarPubMed
145Cariou, R, Tobelem, G, Soria, C et al. Inhibition of protein C activation by endothelial cells in the presence of lupus anticoagulants. N Eng J Med 1986; 314: 1193–94.Google Scholar
146Harris, EN, Gharavi, AE, Louizou, S et al. Cross reactivity of antiphospholipid antibodies. J Clin Lab Immunol 1985; 16: 16.Google ScholarPubMed
147Derkson, RHWM, Bieswa, D, Bouma, BN et al. Discordant effects of prednisone on anticardiolipin antibodies and the lupus anticoagulant. Arth Rheum 1986; 29: 1295–96.CrossRefGoogle Scholar
148Lockshin, MD, Druzin, ML, Goei, S et al. Antibody to cardiolipin as a predictor of fetal distress or death in pregnant patients with systemic lupus erythematosus. N Eng J Med 1985; 313: 152–56.CrossRefGoogle ScholarPubMed
149Harris, EN, Chan, JKH, Asherson, RA, Aber, VR, Gharavi, AE.Thrombosis, recurrent fetal loss, and thrombocytopenia. Arch Intern Med 1986; 146: 2153–56.CrossRefGoogle ScholarPubMed
150Nilsson, IM, Astedt, B, Hedner, U, Berezin, D.Intrauterine death and circulating anticoagulant. Acta Med Scand 1975; 197: 153–59.CrossRefGoogle ScholarPubMed
151Scott, JR, Rote, NS, Branch, DW.Immunologic aspects of recurrent abortion and fetal death. Obstet Gynecol 1987; 70: 645–56.Google ScholarPubMed
152Hughes, GRV.Vascular disease, thrombosis and recurrent abortion. Br Med J 1988; 297: 700701.CrossRefGoogle ScholarPubMed
153de Wolf, F, Carreras, LO, Moerman, P, Vermylen, J, van Assche, A, Renaer, M.Decidual vasculopathy and extensive placental infarction in a patient with repeated thromboembolic accidents, recurrent fetal loss and a lupus anticoagulant. Am J Obstet Gynecol 1982; 142: 829–34.CrossRefGoogle Scholar
154Branch, DW, Scott, JR, Kochenour, NK, Hershgold, E.Obstetric complications associated with the lupus anticoagulant. N Eng J Med 1985; 313: 1322–26.CrossRefGoogle ScholarPubMed
155Lubbe, WF, Butler, WS, Palmer, SJ, Liggins, GC.Lupus anticoagulant in pregnancy. Br J Obstet Gynaecol 1984; 91: 357–63.CrossRefGoogle ScholarPubMed
156Lubbe, WF, Walker, EB.Chorea gravidarum associated with circulating lupus anticoagulant: successful treatment of pregnancy with prednisone and aspirin therapy. Br J Obstet Gynaecol 1983; 90: 487–90.CrossRefGoogle ScholarPubMed
157Boxer, M, Ellman, L, Carvalho, A.The lupus anticoagulant. Arth Rheum 1976; 19: 1244–48.CrossRefGoogle ScholarPubMed
158Mannucci, PM, Canciani, MT, Mari, D et al. The varied sensitivity of partial thromboplastin and prothrombin reagents in the demonstration of the lupus-like anticoagulant. Scand J Haematol 1979; 22: 423–32.CrossRefGoogle ScholarPubMed
159Exner, T, Richard, RA, Kronenberg, H.A sensitive test demonstrating lupus anticoagulant and its behavioural patterns. Br J Haematol 1978; 40: 143–51.CrossRefGoogle ScholarPubMed
160Thiagarajan, P, Pengo, V, Shapiro, S.The use of the dilute Russel Viper Venom Time for the diagnosis of lupus anticoagulant. Blood 1986; 68: 869–74.CrossRefGoogle Scholar
161Lubbe, WF, Butler, WS, Palmer, SJ, Liggins, GC.Fetal survival after prednisone suppression of material lupus-anticoagulant. Lancet 1983; 1: 1361–63.CrossRefGoogle Scholar
162Trudinger, BJ, Stewart, GJ, Cook, CM, Connelly, A, Exner, T.Monitoring lupus anticoagulant positive pregnancies with umbilical flow velocity waveforms. Obstet Gynecol 1988; 72: 215–18.Google Scholar
163Feinstein, DI.Lupus anticoagulant, thrombosis, and fetal loss. N Eng J Med 1985; 313: 1348–50.CrossRefGoogle ScholarPubMed
164Elder, MG, de Swiet, M, Robertson, A, Elder, MA, Floyd, E, Hawkins, DF.Low dose aspirin in pregnancy Lancet 1988; 1: 410.CrossRefGoogle ScholarPubMed
165Cross, JN, Castro, PO, Jennett, WB.Cerebral strokes associated with pregnancy and the puerperium. Br Med J 1968; 3: 214–18.CrossRefGoogle ScholarPubMed
166Wiebers, DO, Whisnant, JP.The incidence of stroke among pregnant women in Rochester, Minn, 1955–1979. JAMA 1985; 254: 3055–57.CrossRefGoogle Scholar
167Srinivasan, K.Cerebral venous and arterial thrombosis in pregnancy and puerperium. Angiol J Vase Dis 1983; 34: 731–46.Google ScholarPubMed
168Halpern, JP, Morris, JGL, Driscoll, GL.Anticoagulants and cerebral venous thrombosis. Aust New Zealand J Med 1984; 14: 643–48.CrossRefGoogle ScholarPubMed
169Bousser, MG, Chiras, J, Bories, J, Castaigne, P.Cerebral venous thrombosis – a review of 38 cases. Stroke 1985; 16: 199213.CrossRefGoogle ScholarPubMed
170Barnett, HJM, Hyland, HH.Non-infective intracranial venous thrombosis. Brain 1953; 76: 3649.CrossRefGoogle Scholar