Faculty of Medicine

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Language: search.filters.language.EnglishSubject: search.filters.subject.Puerperium

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    Recurrence of venous thromboembolism in patients with recent gestational deep vein thrombosis or pulmonary embolism: Findings from the RIETE Registry
    (Elsevier, 2016)
    Barillari G
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    Londero AP
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    Brenner B
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    Nauffal D
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    Muñoz-Torrero JF
    Introduction: The aim of this study was to investigate the recurrence rate of venous thromboembolism (VTE) and the prevalence of major bleeding or death in patients with previous VTE in pregnancy and puerperium. Risk factors for VTE recurrence were also assessed. Materials and methods: We evaluated a cohort of patients enrolled in the international, multicenter, prospective Registro Informatizado de la Enfermedad Trombo-Embólica (RIETE) registry with objectively confirmed VTE. Results: In the registry, 607 women were presenting with VTE that occurred during pregnancy or puerperium. The 2-year VTE recurrence rate was 3.3% (CI: 95 1.5-5.0%) and the recurrent VTE incidence rate was 2.28events/100 patients-year. Among the 16 cases of VTE recurrence 11 cases appeared during drug treatment while only five cases were diagnosed after therapy discontinuation. No significant difference was found in treatment duration among these two subgroups of VTE recurrence cases and women without recurrence. Furthermore, the use of thrombolytics and inferior vena cava filter in initial treatment was associated to an increased risk of VTE recurrence. Conclusions: The current study provides new insights on VTE recurrence rate in patients with deep vein thrombosis (DVT) or pulmonary embolism (PE) that occurred in pregnancy or postpartum period. These findings can contribute to risk assessment of thrombotic burden, thereby allowing for better decision making regarding antithrombotic management in this clinical setting.
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    Enormous Pyosaplinx after Spontaneous Delivery
    (Austin Publishing Group, 2022)
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    Vangelov, A.
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    Enormous pyosalpinx after a spontaneous childbirth is very rare event. Illness and progressive fever accompanied by abdominal or pelvic masses, vaginal purulent discharge, pain and pelvic discomfort, days to weeks after spontaneous delivery should add a suspicion for this condition. Ultrasound examination is the principle tool that can visualize enlarged tube. In this article, we report a 38 year old woman with a post-partum enormous pyosalpinx in which the microbial agent was not identified. Progressively severe symptoms, such as vaginal discharge, abdominal and pelvic pain, malaise and high fever started 5 days postpartum. An exploratory laparotomy showed left enormous pyosalpinx and massive adhesions with bowel and omentum. An excision of tubal ampoulae and omentum, as well as extensive lavage and drainage were made. Postoperative course was normal and the patient was dismissed in good condition.