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Thrombophilia in pregnancy
Vítková, Magda ; Kvasnička, Jan (advisor) ; Hájek, Zdeněk (referee) ; Penka, Jaroslav (referee)
5 ABSTRACT Background: Thromboembolic disease is one of the most common causes of pregnant women morbidity and mortality. The pregnancy period is often the first time, when the apparent congenital or acquired thrombophilia is identi- fied. Patients with thrombophilia have an increased risk of pregnancy compli- cations. The optimal anticoagulant prophylaxis helps to prevent these compli- cations. Methods: The presented work is focused on monitoring of coagulation param- eters, blood counts and acute phase proteins in pregnant women (N = 68) with thrombophilia treated with enoxaparin during pregnancy and it is also con- cerned with evaluation of effectiveness of anticoagulant therapy during preg- nancy using anti FXa activity determination based on inhibition of FXa weight, coagulation parameters and acute phase proteins. In the first and the second part of the study, there is no control group of pregnant patients with severe thrombophilia, but no anticoagulation - this is justified by ethical rea- sons. In the third part, we examined by questionnaire our patients for enoxap- arin adverse reactions at the injection site. Finally, the last part is focused on evaluation of enoxaparin effects on bone remodelling markers, compared with a group of pregnant women without anticoagulation. Results: During the...
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Contribution to the pathophysiology of thrombophilic state after fractures surgery in patients over 75 years old
Kudrnová, Zuzana ; Kvasnička, Jan (advisor) ; Dyr, Jan (referee) ; Malý, Jaroslav (referee)
Introduction: Hip fracture surgery is the particular problem of very old patinets (>75 years), with high risk of VTE (up to 80%). It is essential to provide VTE prophylaxis. Patients advanced age and their polymorbidity contribute to the thrombophilic status. Objectives and methods: The aim of the study was to determine the changes of coagulation within the 28 post-operative days in 41 patients over 75 years who underwent hip fracture surgery. Another object was to determine acute phase response and an endothelial activation. The third task was to determine how affected is a key component of hemostasis, FXa activity by its specific inhibitor fondaparinux and enoxaparin, which inhibits FXa and thrombin in a 4:1 ratio and if there is bleeding complication in such a risk group patiens after antithrombotics long-term administration. Patients were randomly divided into two anticoagulant groups: fondaparinux (n = 23) and enoxaparin (n = 18). Results: Thrombophilia is demonstrated by a reactive increase of the most of these parameters preoperatively and reveals the effect of the initial trauma. A surgery further aggravates this reaction. This inflammatory and secondary prothrombogenic condition persisted until postoperative day 28. Both antithrombotics effectively inhibit thrombin generation without...
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Thrombophilia in pregnancy
Vítková, Magda ; Kvasnička, Jan (advisor) ; Hájek, Zdeněk (referee) ; Penka, Jaroslav (referee)
5 ABSTRACT Background: Thromboembolic disease is one of the most common causes of pregnant women morbidity and mortality. The pregnancy period is often the first time, when the apparent congenital or acquired thrombophilia is identi- fied. Patients with thrombophilia have an increased risk of pregnancy compli- cations. The optimal anticoagulant prophylaxis helps to prevent these compli- cations. Methods: The presented work is focused on monitoring of coagulation param- eters, blood counts and acute phase proteins in pregnant women (N = 68) with thrombophilia treated with enoxaparin during pregnancy and it is also con- cerned with evaluation of effectiveness of anticoagulant therapy during preg- nancy using anti FXa activity determination based on inhibition of FXa weight, coagulation parameters and acute phase proteins. In the first and the second part of the study, there is no control group of pregnant patients with severe thrombophilia, but no anticoagulation - this is justified by ethical rea- sons. In the third part, we examined by questionnaire our patients for enoxap- arin adverse reactions at the injection site. Finally, the last part is focused on evaluation of enoxaparin effects on bone remodelling markers, compared with a group of pregnant women without anticoagulation. Results: During the...
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Contribution to the pathophysiology of thrombophilic state after fractures surgery in patients over 75 years old
Kudrnová, Zuzana ; Kvasnička, Jan (advisor) ; Dyr, Jan (referee) ; Malý, Jaroslav (referee)
Introduction: Hip fracture surgery is the particular problem of very old patinets (>75 years), with high risk of VTE (up to 80%). It is essential to provide VTE prophylaxis. Patients advanced age and their polymorbidity contribute to the thrombophilic status. Objectives and methods: The aim of the study was to determine the changes of coagulation within the 28 post-operative days in 41 patients over 75 years who underwent hip fracture surgery. Another object was to determine acute phase response and an endothelial activation. The third task was to determine how affected is a key component of hemostasis, FXa activity by its specific inhibitor fondaparinux and enoxaparin, which inhibits FXa and thrombin in a 4:1 ratio and if there is bleeding complication in such a risk group patiens after antithrombotics long-term administration. Patients were randomly divided into two anticoagulant groups: fondaparinux (n = 23) and enoxaparin (n = 18). Results: Thrombophilia is demonstrated by a reactive increase of the most of these parameters preoperatively and reveals the effect of the initial trauma. A surgery further aggravates this reaction. This inflammatory and secondary prothrombogenic condition persisted until postoperative day 28. Both antithrombotics effectively inhibit thrombin generation without...
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