Hemorrhagic and thrombotic complications in pregnancy: diagnosis, prevention, and treatment

Alvarado C.S.; Celis-López A.; Guevara-Ríos E.; García-Lázaro P.; Lovato-Ríos P. · Anales de la Facultad de Medicina (2023) · DOI: 10.15381/anales.v84i1.23547

Resumen

Bleeding and venous thromboembolism (VTE) are among the five most common causes of morbidity and mortality in pregnant women worldwide. This review describes the current evaluation and management of the obstetric causes of postpartum hemorrhage (PPH), as well as the diagnosis and management of hematologic conditions which can cause or worsen PPH, such as disseminated intravascular coagulation, von Willebrand disease, autoimmune thrombocytopenia and the thrombotic microangiopathies. It also describes the role of the antiphospholipid syndrome and inherited thrombophilia as predisposing factors for recurrent pregnancy loses and VTE, and the current recommendations for the prevention of both complications. As well, the current diagnostic approach and management of ETEV are described. An additional objective of this Review is to emphasize the importance of a collaborative multidisciplinary approach for the successful management of the obstetric and hematologic complications herein described.

Instituciones: Universidad Nacional Mayor de San Marcos; Universidad Privada Antenor Orrego; Universidad Nacional de Cajamarca