Reduction of Thromboembolic Disorders in Pregnancy and Postpartum Period: Role of National Pregnancy Heart Team

I. Davydova^1,2, S. Siromakha³, A. Rusnak⁴, A. Ogorodnyk¹, V. Lazoryshynets⁵

¹Institute of Pediatrics, Obstetrics and Gynecology National Academy of Medical Sciences of Ukraine, High Risk Pregnancy, Kyiv, Ukraine, ²National Institute of Cardiovascular Surgery named after M.Amosov, National Academy of Medical Sciences of Ukraine, Obstetric Cardiology, Kyiv, Ukraine, ³National Institute of Cardiovascular Surgery named after M.Amosov, National Academy of Medical Sciences of Ukraine, CHD, Kyiv, Ukraine, ⁴National Institute of Cardiovascular Surgery named after M.Amosov, National Academy of Medical Sciences of Ukraine, Infectious Endocarditis Surgery Treatment, Kyiv, Ukraine, ⁵National Institute of Cardiovascular Surgery Named after M.Amosov, National Academy of Medical Sciences of Ukraine, Director, Kyiv, Ukraine

Abstract Number: PB2548

Meeting: ISTH 2020 Congress

Theme: Women Health » Pregnancy and Pregnancy Complications

Background: DVT and PE rank fourth place in Ukraine among the causes of maternal mortality. The National pregnancy heart team (NPHT) has been formed in 2013 by common efforts of National Institute of Cardiovascular Surgery (NICVS) and Institute of Pediatrics, Obstetrics and Gynecology.

Aims: To reduce maternal mortality and disability rates from DVT/PE by improving diagnostic and treatment programs in pregnancy and puerperium including activities of NPHT.

Methods: There were analyzed eight cases of DVT/PE in pregnancy and puerperium, occurred at 2014-2018. Seven patients were transferred to the NICVS and one patient was treated by NPHT on site in the regional perinatal center. There were performed four thrombectomies with CPB, 1 cava-filter insertion after failed thrombolysis, three patients successfully passed through the LWMH (enoxaparin).

Results: There were no cases of maternal mortality of severe maternal morbidity. The uneventful course of pregnancy resulted in full-term birth occurred in two cases, one pregnancy resulted in miscarriage of twin gestation in 18 gestational weeks, all the other cases concerned the puerperal period. The debriefing of all the cases allowed to establish the new approach for thromboprophylaxis in Ukraine, based on the risk stratification in every pregnant within her first prenatal visit, hospitalization for non-pregnancy related disorders, hospitalization for pregnancy disorders, labour and delivery, ambulance stage after discharge from maternity institution. The diagnostic algorithm for VTE, as well as for timely treatment of DVT/PE, choice of optimal method (or combination of methods) for treatment, especially in group of high risk of mortality was presented for the cardiology, cardiosurgery departments and perinatal centers in Ukraine.

Conclusions: A multidisciplinary approach at all stages of VTE diagnosis in pregnant women / women in childbirth is a necessary component of cardiac and obstetric care for pregnant women with VTE and enables efficient use of resources (avoiding duplication of functions).

To cite this abstract in AMA style:

Davydova I, Siromakha S, Rusnak A, Ogorodnyk A, Lazoryshynets V. Reduction of Thromboembolic Disorders in Pregnancy and Postpartum Period: Role of National Pregnancy Heart Team [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/reduction-of-thromboembolic-disorders-in-pregnancy-and-postpartum-period-role-of-national-pregnancy-heart-team/. Accessed November 29, 2021.

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