DEEP VEIN THROMBOSIS IN PREGNANCY Case report

Prikazana je 26 godišnja prvorotkinja s dubokom venskom trombozom lijeve noge, koja je na kliniku primljena s 29/30 tjedana trudnoće. Po prijemu ustanovljeno da se radi i o centralnoj placenti previji. Odmah je uključena antikoagulantna terapija (heparin), pacijentica je mirovala s eleviranom nogom. Primala i antibiotike. Svakodnevno vršena kontrola APTT-a i doza heparina korigirana prema tim vrijednostima. Nakon 15 dana antikoagulantne terapije trudnoća je završena elektivnim carskim rezom. Rođeno je živo žensko novorođenče tjelesne težine 1360 grama. Postoperativni tijek je protekao uredno, rana zarasla per primam. U postoperativnom tijeku uključen Marivarin. Šesti postoperativni dan urađena CT flebografija abdomena i zdjelice s 3D rekonstrukcijom. Na venskom sistemu viđene su trombotičke mase u veni femoralis sinistri, veni ilijaki eksterni sinistri i veni ilijaki komunis sinistri. Pacijentica i dalje pod intenzivnom antikoagulantnom terapijom uz kontrolu laboratorijskih nalaza. 37 dana nakon carskog reza otpuštena kući. Novorođenče nakon rođenja imalo respiratorni distres sindrom i intrakranijalnu hemoragiju. Četiri dana bilo na kontroliranoj mehaničkoj ventilaciji. Nakon 50 dana boravka na Odjelu za novorođenčad, novorođenče vitalno, s konstantnim prirastom tjelesne težine, s urednim laboratorijskim i mikrobiološkim nalazima, otpušta se na kućnu njegu. Tjelesna težina pri otpustu 1570 grama.A 26-year old patient, first pregnancy, with deep venous thrombosis of left leg was admitted to hospital at 29/30 weeks of gestation. She had central placenta praevia. Anticoagulant therapy and antibiotics started from the beginning, patient was with elevated leg in the bed. Every day APTT was controlled and the dose of Heparin was changed according to level of APTT. After 15 days of anticoagulant therapy pregnancy was accomplished by elective Caesarean section. Live female newborn was born with body weight 1360 g. During postoperative period patient was in good condition and was on the therapy with Marivarin. On 6th postoperative day CT phlebography of abdomen and pelvis with 3D reconstruction was made. Thrombotic masses were found in v. femoralis sin, v. iliaca externa and v. iliaca communis sin. Anticoagulant therapy was continued with control of biochemical analysis. 37 days after Caesarean section the patient was discharged. The newborn had respiratory distress syndrome and intracranial bleeding and was during four days on mechanical ventilation. After 50 days in hospital the child was in good condition with good biochemical and microbiological analysis and left hospital with body weight 1570 g