Información del artículo
Resumen
Introducción
La heparina de bajo peso molecular (HBPM) es el tratamiento anticoagulante de elección para el tratamiento de la enfermedad tromboembólica venosa (ETV) durante la gestación y la lactancia. Los antagonistas de vitamina K (AVK) están contraindicados durante las semanas seis a 12 por relacionarse con una embriopatía específica y en el tercer trimestre por el riesgo hemorrágico. Los anticoagulantes orales de acción directa (ACOD) están contraindicados en el embarazo y la lactancia por riesgo de malformaciones prenatales. Técnicas de reperfusión, como la fibrinólisis sistémica o la trombectomía mecánica, se reservan para casos de embolia pulmonar (EP) con inestabilidad hemodinámica.
Métodos y resultadosEste documento de consenso, elaborado por las Sociedades Españolas de Medicina Interna (SEMI), de Radiología Médica (SERAM), de Radiología Vascular e Intervencionista (SERVEI) y Sociedad Española de Ginecología y Obstetricia (SEGO), realiza una revisión exhaustiva de la evidencia más reciente sobre el tratamiento de la ETV en la paciente gestante y actualiza las recomendaciones.
Palabras clave:
Embarazo
Embolia pulmonar
Enfermedad tromboembólica venosa
Gestación
Tratamiento
Trombosis venosa profunda
Abstract
Introduction
Low-molecular-weight heparin is the anticoagulant treatment of choice for managing venous thromboembolism (VTE) during pregnancy and lactation. Vitamin K antagonists are contraindicated between weeks 6-12 of gestation due to their association with a specific embryopathy, and during the third trimester due to the risk of bleeding. Direct oral anticoagulants are contraindicated during pregnancy and breastfeeding because of the risk of prenatal malformations. Reperfusion techniques, such as systemic thrombolysis or mechanical thrombectomy, are reserved for cases of pulmonary embolism with hemodynamic instability.
Methods and resultThis consensus document, developed by the Spanish Societies of Internal Medicine, Medical Radiology, Vascular and Interventional Radiology, and Gynecology and Obstetrics, provides a comprehensive review of the most recent evidence on the treatment of VTE in pregnant patients and updates current recommendations.
Keywords:
Pregnancy
Pulmonary embolism
Venous thromboembolism
Gestation
Treatment
Deep venous thrombosis
Artículo
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