The Morbidity Of Deep Venous Thrombosis In Perinatal Period And Its Early Prediction

Objective: To investigate morbidity of deep venous thrombosis (DVT) , pulmonary embolism(PE) and its high risk factors during perinatal period.we measured the changes of the hemorrheology and fibrinolytic system and evaluate its function in patients who have high risk factors. Some effective methods for prevention are also discussed in our study.Methods:1 .we retrospectively reviewed thrornboembolisrn(deep venous thrombosis and pulmonary embolism)cases from 18 hospitals at Guangzhou city from January 1991 to december 2000.We conducted a retrospective case-control study of all women during perinatal period and to explore the high risk factors.2.Blood smaples were collected from in perinatal period women who have high risk factors in Nanfang hospital, while the controls are those from non-pregnant women and normal late pregnant women in the third-term. The contents of vWF, GMP-140, t-PA in plasma were determined by a sandwich ELISA method. Fbg, PLG , D-Dimer ,PAI, ,AT-III coagulate method respectively.Results:1. There were 39(0.042%) patients of venous thromboembolism(deep venous thrombosis and pulmonary embolism). Among 93651 deliveriesincluding 36 cases of deep venous thromboembolism,3 cases of pulmonary embolism (0.003%) and 2 cases of dead(0.002%). The high risk factors of all women in perinatal period are cesarean deliverry , increasing parturition, pregnancy induced hypertation, application hemostatic drug.postpartum hemorrhage, transfuse, complication and prolonged bed rest (P<0.05).2. In test group vWF[(139.8+31.7)%],GMP-140[(14.1 +4.6)ug/L], Fbg[(15.5 + 0.8)g/L], PLG [(146.8 + 11.1)%], D-Dimer[(1.61 + 0.68)mg/L] ,PA1[(9.91 + 0.7 l)kU/L] were obviously higher than those of control groups. AT-III,PCAT in test group were lower than the control groups(P<0.01). t-PA has no significant differences (P>0.05) .Conclusions:1. The morbidities of DVT, PE in investigated patients were less than those in Western Country. The high risk factors Of all women in perinatal period are cesarean deliverry, increasingparturition, pregnancy induced hypertation,application hemostatic drug,postpartumhemorrhage, transfuse, complication and prolonged bed rest.2.The content of vWF, Fbg, PLG ,D-Dimer,PAI increased in normal pregant women, Prethrombotic state was shown in normal of late pregnancy women . Those might be a compensation change for the increasing of blood volume and progesterone-mediated increases in venous distensibility and capacity are evident early ingestation.3. The content of vWF,GMP-140, Fbg, PLG ,D-Dimer,PAI increaed in test group than the normal late pregnant women, then obviously prethrombotic state was shown in Patients who have the high factors.4.The measure of prediction DVT\PE must be done in the normal pregnant women and the patient who have the risk factors in gestation.