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Despite intensive research, venous thromboembolism still accounts for significant maternal mortality and morbidity. The article describes modern aspects of the pathogenesis, diagnosis, treatment, primary and secondary prevention of venous thromboembolism during pregnancy. Thrombophilia might be the essential pathogenetic mechanism of thromboembolism associated with pregnancy. Low molecular weight heparin (LMWH) is effective for prevention of recurrent thromboembolism and obstetric complications. Women with personal or family history of thromboembolism or with history of obstetric complications should be screened for thrombophilia.

About the Authors

S. V. Akinshina
First Moscow State Medical Sechenov University of the Ministry of Health Russian Federation
Russian Federation

A. D. Makatsariya
First Moscow State Medical Sechenov University of the Ministry of Health Russian Federation
Russian Federation

V. O. Bitsadz
First Moscow State Medical Sechenov University of the Ministry of Health Russian Federation
Russian Federation

M. D. Andreeva
First Moscow State Medical Sechenov University of the Ministry of Health Russian Federation
Russian Federation


1. Akin’shina S.V., Makatsariya A.D., Bitsadze V.O., Stuleva N.S., Mashkova T.Ya. Akusherstvo, ginekologiya i reproduktsiya. 2014; 2: 89-96.

2. Vlasov P.N. Epilepsiya i paroksizmal’nye sostoyaniya. 2009; 1: 8-13.

3. Krysanov I.S. Farmakoekonomika. Sovremennaya farmakoekonomika i farmakoepidemiologiya. 2009; 1: 42-47.

4. Makatsariya A.D., Akin’shina S.V. Akusherstvo, ginekologiya i reproduktsiya. 2014; 2: 97-111.

5. Makatsariya A.D., Bitsadze V.O. Thrombophilia and antithrombotic therapy in obstetric practice [Trombofilii i protivotromboticheskaya terapiya v akusherskoi praktike]. Moscow. 2003; 904 s.

6. Abrahams V.M. Mechanisms of antiphospholipid antibody-associated pregnancy complications. Thromb Res. 2009 Nov; 124 (5): 521-5.

7. Alafar S. Bemiparin versus low dose aspirin for management of recurrent early pregnancy losses due to antiphospholipd antibody syndrome. Arch. Gynecol. Obstet. 2012; 285: 641-647.

8. Alferivic Z., Roberts D., Martlew V. How strong is the association between maternal thrombophilia and adverse pregnancy outcome. Eur. J. Obstet. Gyencol. Reprod. Biol. 2002; 101: 6-14.

9. Anderson F.A. Jr., Spencer F.A. Risk Factors for Venous Thromboembolism. Circulation. 2003; 107; 9-16.

10. Avdonin P.V., Kirienko A.I., Kozhevnikova L.M., Shostak N.A., Babadaeva N.M., Leont’ev S.G., Petukhov E.B., Kubatiev A.A., Savel’ev V.S. C677T mutation in methylentetrahydrofolatered uctase gene in patients with venous thromboses from the central region of Russia correlates with a high risk of pulmonary artery thromboembolism. Ter. Arkh. 2006; 78 (6): 70-6.

11. Bates S.M., Greer I.A., Middeldorp S., Veenstra D.L., Prabulos A.M., Vandvik P.O. American College of Chest Physicians. VTE, thrombophilia, antithrombotic therapy, and pregnancy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012 Feb; 141 (2): e691S-736S.

12. Bick R.L., Frenkel E.P., Backer W.F., Sarode R. Hematological complications in obstetrics, pregnancy, and gynecology.UK, Cambridge University press. 2006; p. 604.

13. Brenner B. Haemostatic changes in pregnancy. Thromb. Res. 2004; 114 (5-6): 409-14.

14. Brill-Edwards P., Ginsberg J.S., Gent M. et al. Recurrence of Clot in This Pregnancy Study Group Safety of withholding heparin in pregnant women with a history of venous thromboembolism. N. Engl. J. Med. 2000; 343 (20): 1439-1444.

15. Butchart E.G., Gohlke-Barwolf C. Anticoagulation management of patients with prosthetic valves. J. Am. Coll. Cardiol. 2004 Sep 1; 44 (5): 1143-4.

16. Cruz M., Fernández-Alonso A.M., Rodríguez I., Garrigosa L., Caño A., Carretero P., Vizcaíno A., Gonzalez-Ramirez A.R. Postcesarean thromboprophylaxis with two different regimens of bemiparin. Obstet Gynecol Int. 2011; 2011:548327 doi: 10.1155/2011/548327.

17. Den Heijer M., Lewington S., Clarke R. Homocysteine, MTHFR and risk of venous thrombosis: a meta-analysis of published epidemiological studies. J. Thromb. Haemost. 2005 Feb; 3 (2): 292-9.

18. DI Nisio M., Squizzato A., Rutjes A.W., Buller H.R., Zwinderman A.H., Bossuyt P.M. Diagnostic accuracy of D-dimer test for exclusion of venous thromboembolism: a systematic review. J. Thromb. Haemost. 2007 Jan 22; 5 (2): 296-304.

19. Frederiksen J., Juul K., Grande P., Jensen G.B., Schroeder T.V., Tybjaerg-Hansen A., Nordestgaard B.G. Methylenetetrahydrofolate reductase polymorphism (C677T), hyperhomocysteinemia, and risk of ischemic cardiovascular disease and venous thromboembolism: prospective and casecontrol studies from the Copenhagen City Heart Study. Blood. 2004 Nov 15; 104 (10): 3046-51.

20. Gerhardt A., Scharf R.E., Beckmann M.W., Struve S., Bender H.G., Pillny M., Sandmann W., Zotz R.B. Prothrombin and factor V mutations in women with a history of thrombosis during pregnancy and the puerperium. N. Engl. J. Med. 2000 Feb 10; 342 (6): 374-80.

21. Girling J., de Swiet M. Inherited thrombophilia and pregnancy. Curr. Opin. Obstet. Gynecol. 1998 Apr; 10 (2): 135-44.

22. Goodnight S.H., Hathaway W.E. Disordes of haemostasis and thrombosis. Clinical guide. Second edition. McGraw-Hill, Inc. 2001; p.622.

23. Greer I.A., Nelson-Piercy C. Low-molecularweight heparins for thromboprophylaxis and treatment of venous thromboembolism in pregnancy: a systematic review of safety and efficacy. Blood. 2005; 106 (2): 401-407.

24. Hirsh J., Guyatt G., Albers G.W., Harrington R., Sch nemann H. J. Antithrombotic and Thrombolytic Therapy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest June 2008; 133: 110-112.

25. Jacob H., Rand, Xiao-Xuan Wn. Antibody- Mediated Disruption of the Annexin-V Antithrombotic Shield: a new Mechanism for Thrombosis in the Antiphospholipid Syndrome. Thromb. And Hemost. 1999; 82 (2): 649-656.

26. Kearon C., Gent M., Hirsh J., Weitz J., Kovacs M.J., Anderson D.R., Turpie A.G., Green D., Ginsberg J.S., Wells P., MacKinnon B., Julian J.A. A comparison of three months of anticoagulation with extended anticoagulation for a first episode of idiopathic venous thromboembolism. N. Engl. J. Med. 1999 Mar 25; 340 (12): 901-7.

27. Koniari I., Siminelakis S.N., Baikoussis N.G., Papadopoulos G., Goudevenos J., Apostolakis E. Antiphospholipid syndrome; its implication in cardiovascular diseases: a review. J. Cardiothorac Surg. 2010 Nov 3; 5: 101.

28. Miyakis S., Lockshin M.D., Atsumi T., Branch D.W., Brey R.L., Cervera R., Derksen R.H., DE Groot P.G., Koike T., Meroni P.L., Reber G., Shoenfeld Y., Tincani A., Vlachoyiannopoulos P.G., Krilis S.A. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J. Thromb Haemost. 2006 Feb; 4 (2): 295-306.

29. Nicolaides A.N., Fareed J., Kakkar A.K. et al. Prevention and treatment of venous thromboembolism-International Consensus Statement. Int. Angiol. 2013 Apr; 32 (2): 111-260.

30. Ratnapalan S., Bentur Y., Koren G. «Doctor, will that X-ray harm my unborn child?». CMAJ. 2008 Dec 2; 179 (12): 1293-6.

31. Ray J.G., Chan W.S. Deep vein thrombosis during pregnancy and the puerperium: a metaanalysis of the period of risk and the leg of presentation. Obstet. Gynecol. Surv. 1999 Apr; 54 (4): 265-71.

32. Rey E., Kahn S.R., David M. et al. Thrombophilic disorders and fetal loss: a metaanalysis. Lancet 2003; 361:901-908.

33. Robertson L., Greer I. Thromboembolism in pregnancy. Curr. Opin. Obstet. Gynecol. 2005 Apr; 17 (2): 113-6.

34. Simioni P., Tormene D., Spiezia L., Tognin G., Rossetto V., Radu C., Prandoni P. Inherited thrombophilia and venous thromboembolism. Semin. Thromb. Hemost. 2006 Oct; 32 (7): 700-8.




For citations:

Akinshina S.V., Makatsariya A.D., Bitsadz V.O., Andreeva M.D. CLINICAL PICTURE, DIAGNOSIS AND PREVENTION OF VENOUS THROMBOEMBOLIC COMPLICATIONS DURING PREGNANCY. Obstetrics, Gynecology and Reproduction. 2014;8(4):27-36. (In Russ.)

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ISSN 2313-7347 (Print)
ISSN 2500-3194 (Online)