Medikamentöse Thromboembolie-Prophylaxe in Gynäkologie und Geburtshilfe

Zusammenfassung

Venöse Thromboembolien (VTE) gehen mit hoher Morbidität und Mortalität einher. Wirksame Maßnahmen zur sicheren VTE-Prophylaxe stellen deshalb weiterhin eine Herausforderung in der täglichen klinischen Praxis dar. Dies trifft vor allem auf Schwangere und Patientinnen mit gynäkologischen Malignomen zu. Niedermolekulare Heparine sind nach wie vor Mittel der Wahl zur medikamentösen VTE-Prophylaxe perioperativ, bei Risikoschwangerschaft und in der Postpartalphase. Allerdings können diese Substanzen Blutungen oder eine heparininduzierte Thrombozytopenie (Typ II) auslösen. Auf der Grundlage aktualisierter Leitlinien bietet dieser Artikel eine Übersicht zum Stand der medikamentösen Thromboembolie-Prophylaxe und erörtert Probleme und offene Fragen.

Summary

Venous thromboembolism (VTE) is associated with high morbidity and mortality. Therefore, effective methods for safe thrombo prophylaxis remain an ongoing challenge in daily clinical practice. This is especially true for pregnant women and patients with gynaecological malignancies. Low-molecular weight heparins continue to be agents of choice for pharmacological thromboprophylaxis postoperatively, in pregnant patients at risk, and during the puerperium. However, these drugs can cause bleeds or heparin-induced thrombocytopenia (type II). Based on recent revisions of corresponding guidelines, this article provides an overview of the current state of pharmacological thromboprophylaxis and discusses prevailing problems and unresolved issues.

Schlüsselwörter

Pharmakologische Thromboembolie-Prophylaxe - Heparine - rekombinante und synthetische Antikoagulanzien - Tumorkrankheit - Schwangerschaft

Keywords

Pharmacological thromboprophylaxis - heparins - recombinant and synthetic anticoagulants - cancer - pregnancy

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