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Underlying prothrombotic states in pregnancy associated cerebral venous thrombosis

Aaron, S ; Alexander, M ; Maya, T ; Mathew, V ; Goel, M ; Nair, S C ; Mammen, J ; Vikram, M

Neurology India, 2010-07, Vol.58 (4), p.555-559 [Periódico revisado por pares]

India: Medknow Publications and Media Pvt. Ltd

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Título:
Underlying prothrombotic states in pregnancy associated cerebral venous thrombosis
Autor: Aaron, S ; Alexander, M ; Maya, T ; Mathew, V ; Goel, M ; Nair, S C ; Mammen, J ; Vikram, M
Assuntos: Abortion ; Adult ; Analysis of Variance ; Anticoagulants ; Chi-Square Distribution ; Cohort Studies ; Diagnosis ; Factor V - metabolism ; Female ; Fibrinolytic Agents - therapeutic use ; Health aspects ; Health risk assessment ; Heparin - therapeutic use ; Humans ; India ; Intracranial Thrombosis - etiology ; Intracranial Thrombosis - metabolism ; Intracranial Thrombosis - therapy ; Methylenetetrahydrofolate Reductase (NADPH2) - metabolism ; Mortality ; Mutation ; Postpartum period ; Pregnancy ; Pregnancy Complications, Hematologic - metabolism ; Pregnant women ; Prothrombin - metabolism ; Risk Factors ; Teaching hospitals ; Venous thrombosis ; Venous Thrombosis - etiology ; Venous Thrombosis - metabolism ; Venous Thrombosis - therapy ; Water Deprivation - physiology ; Young Adult
É parte de: Neurology India, 2010-07, Vol.58 (4), p.555-559
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
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Descrição: The exact pathogenesis of pregnancy associated cerebral venous thrombois is still unsettled. Aims : To identify possible inherited and acquired prothrombotic risk factors and also identify the factors associated with mortality in pregnancy associated CVT. Prospective cohort study to identify prothrombotic risk factors and case control study of influence of local traditional practice of puerperal water restriction on postpartum CVT. Consecutive patients with pregnancy associated CVT seen over a period of three years. Thrombotic workup included genetic markers, protein assays, and other factors. Univariate and chi-square analysis. Of the 41 patients studied during the study period, 71% of patient had a single and 34% had multiple prothrombotic risk factors. Methylene tetrahydro-folate reductase (MTHFR) heterozygosity (19.5%) and factor V Leiden heterozygous (7.3%) were the commonest genetic markers. Hyperhomocysteinemia (34%) and elevated factor VIII levels (14.6%) were the other important risk factors. In this cohort the mortality was 17%. Mortality increased by odds of 1.3 for every additional prothrombotic marker. The factors associated with increased mortality included: status epileptics (P = 0.05, OR 13.2, 95% CI 1.002 - 173), deep venous system involvement (P = 0.016, OR 9.64, 95% CI 1.53 - 60.6), presence of midline shift (P = 0.012, OR 24.7, 95% CI 2.05 - 29.8) and diffuse cerebral edema (P = 0.006, OR 14.5, 95% CI 2.18- 96.4). The traditional practice of decrease intake of water during puerperium was significant in woman with pregnancy associated CVT when compared to control subjects (P < 0.02). In patients with pregnancy associated CVT, prothrombotic markers can be multiple and are associated with increased odds of mortality. Deep venous system involvement, presence of midline shift and diffuse cerebral edema increased mortality. Peuperial water restriction may be a modifiable risk factor.
Editor: India: Medknow Publications and Media Pvt. Ltd
Idioma: Inglês

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Underlying prothrombotic states in pregnancy associated cerebral venous thrombosis

Aaron, S ; Alexander, M ; Maya, T ; Mathew, V ; Goel, M ; Nair, S C ; Mammen, J ; Vikram, M

India: Medknow Publications and Media Pvt. Ltd

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