Évaluer le risque de maladie veineuse thromboembolique en contexte obstétrical

Résumé fourni par la source

OBJECTIVES: Women are at increased risk of venous thromboembolism (VTE) during pregnancy. Because of the many risk factors (RFs) involved and the need for frequent risk reassessment, VTE risk prediction scores have been developed to increase the adequacy of thromboprophylaxis. This article reviews the various existing VTE risk prediction scores. METHODS: A review on PUBMED using the following medical subject headings - ([pregnancy OR postpartum] AND [score OR risk OR model prediction] AND [venous thromboembolism OR pulmonary embolism OR deep vein thrombosis]) - identified the articles published from January 2000 to May 2024. RESULTS: Out of 2532 articles, 14 risk prediction scores were identified. Some of them apply to specific subpopulations during pregnancy and the postpartum period: (i) women at high risk of VTE; (ii) women at high risk of VTE and placental vascular disorders; (iii) women with obesity; others can be used only in the postpartum period: (i) women at high risk of a first VTE; (ii) women who have given birth by vaginal or caesarean section; (iii) women who have given birth by caesarean section only. Other scores are based on an unselected population. They also differ in the methodology used to develop them, their degree of validation, the RFs considered and the therapeutic management according to the score. CONCLUSION: The use of a VTE risk prediction score has been recommended since 2008. Its importance in clinical practice for VTE risk assessment and the adequacy of thromboprophylaxis has been documented. The use of a single score for pregnant patients would appear to be more appropriate for obstetric practitioners. It will be used by the whole team at each consultation and/or hospital admission.

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