Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.190148
Jornal Vascular Brasileiro
Review Article

Tromboembolismo venoso na mulher: novos desafios para uma velha doença

Venous thromboembolism in women: new challenges for an old disease

André Luiz Malavasi Longo de Oliveira; Adilson Ferraz Paschôa; Marcos Arêas Marques

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Resumo

Resumo: Nos países que controlaram as causas clássicas de óbito materno, como eclâmpsia e hemorragia, o tromboembolismo venoso (TEV) passou a ser a principal preocupação. A prevenção do TEV na gestação e no puerpério, por meio de diretrizes e da instituição de farmacoprofilaxia, é ainda a melhor estratégia para reduzir essa complicação. Os contraceptivos hormonais e a terapia de reposição hormonal também aumentam o risco de TEV; porém, as mulheres não podem ser privadas dos benefícios dessas terapias, que as tornam mais livres na idade fértil e menos sintomáticas na menopausa. Tanto o uso indiscriminado quanto a proibição imotivada são inadequados. A escolha dos métodos contraceptivos e de reposição deve ser feita por criteriosa seleção, avaliando as contraindicações, os critérios de elegibilidade e a autonomia das pacientes. O presente artigo apresenta uma revisão não sistemática da literatura recente visando a avaliar e resumir a associação entre TEV e situações clínicas peculiares ao sexo feminino.

Palavras-chave

trombose, anticoncepcionais, gravidez, terapia de reposição hormonal, mulheres, embolia pulmonar

Abstract

In countries that have controlled classic causes of maternal death, such as eclampsia and hemorrhage, venous thromboembolism (VTE) has become the major concern. Prevention of VTE during pregnancy and postpartum by applying guidelines and implementing pharmacoprophylaxis is still the best strategy to reduce occurrence of this complication. Hormonal contraceptives and hormone replacement therapy also increase the risk of VTE, but women cannot be deprived of their benefits, which increase their freedom at childbearing age and reduce their symptoms at menopause. Both indiscriminate use and unmotivated prohibition are inappropriate. Contraceptive and hormone replacement methods should be chosen with care, evaluating the patients’ contraindications, eligibility criteria, and autonomy. This article presents a nonsystematic review of recent literature with the aim of evaluating and summarizing the associations between VTE and clinical situations peculiar to women.

Keywords

thrombosis; contraceptive agents; pregnancy; hormone replacement therapy; women; pulmonary embolism

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Submitted date:
11/27/2019

Accepted date:
04/29/2020

5eff28190e88253215f8e225 jvb Articles

J Vasc Bras

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