The Clinical Analysis Of Diagnosis And Treatment Of 32 Cases Acute DVT In Perinatal Period

Objective: to explore the diagnosis and treatment of acute deep venous thrombosis of lower limb in perinatal period.Methods: to review and analyze retropectively the data of 32 patients who were diagnosed as DVT in perinatal period from January 1st, 2010 to June 1st 2015. All the DVT patients were suffering from suddenly swell, pain and increasing tension of soft tissue.The diagnosis were confirmed with colour Dopplter ultrasound. 3 patients with DVT, who requested to keep the babies, only applied anticoagulant treatment. 2patients who had no wills to keep the babies, underwent anticoagulant treatment and catheter-directed thrombolysis after pregnancy termination. The rest of them underwent anticoagulant treatment catheter-directed thrombolysis after delivery.The IVC filter were placed before thrombolysis and taken out after thrombolysis.Patients with IVCS implemented balloon dilatation and/or stent implantation.Results: the 3 pregnant women with DVT, who were only applied with anticoagulant treatment, showed a little improvement on both symptoms and signs through the pregnancy. There were no oafs, asphyxia infants or serious complications, such as post-partal hemorrhage. Two cases were followed up for 36 months, and the follow-up rate was 66.7%. All patients were subjected to PTS to different extent. The rest of 29 patients, who completed catheter-directed thrombolysis, had obvious improvement on both symptom and signs. 27 cases completed follow up recently. While 2 were lost to follow-up. The follow-up duration ranged from 6 to 60 months,(Average times was 33.05±19.31 months),and the follow-up rate was 93.10%. One case with DVT relapsed. 4 patients were subjected to PTS to different extent. The symptom and signs in 9 patients out of 27 were ameliorated, who accepted PTA combined with stand implantation. The follow-up for the 9 patients lasted 6 to 58 months(Average times was 30.04±15.31months). The symptoms of the patients were basically alleviated and the thrombus of deep veins of lower limb disappeared shown by emgiography. Out of 6 cases with treatment of only PTA. 5 got follow-up. The follow-up duration ranged from 6to 48 months.(Average times was 21.40±7.04 months). There was no relapse of DIV of lower limb but 1 PTS case relapsed.Conclusions: due to the special patho-physiological changes of the pregnant and lying-in women, the morbidity of DVT in lower limb are higher than the normal group. Therefore, it is critical to prevent DVT in perinatal period. The diagnosis of DVT depend on clinical manifestation, D-dimer and color Doppler ultrasound. The treatment of DVT should weigh all the pros and cons, in terms of safety of mothers and fetus, as well as the requirements of the patients. Doctors may adopt anticoagulant treatment for the patient who request to keep the babies and apply catheter-directed thrombolysis for those don’t accept the termination of pregnancy.The CDT treament could be employed for those in young age and in good shape and high requirement for the quality of life. It can improve therapeutic efficacy in the long run for the patients to received balloon dilatation and/or stent implantation.