International Circulation: Speaking to pregnant women and their elevated risk of deep-vein thrombosis (DVT)， how do we evaluate the risk for these women and who do we ICentify them to prevent this from happening?
   《国际循环》:关于孕妇深静脉血栓（DVT）风险升高，我们如何评估她们的风险，如何预防DVT发生？
    Dr. Le Gal: For primary prevention of DVT， what we know for sure is that if a woman has had a previous episode of DVT， which was related to a previous pregnancy of to the use of birth control， then she needs to be on prophylactic low-molecular weight heparin through the whole pregnancy， from six weeks to postpartum. The same would apply if a woman has a previous， unprovoked DVT or PE. On the other hand， if she has a DVT or PE but that clearly provoked by surgery or something related， then it is usually safe to avoIC prophylaxis during the pregnancy and would only give low-MW heparin during the postpartum period. If the woman has no personal history of DVT， it is very rare that we would give prophylaxis during the pregnancy. This would only be true is she has high-risk thrombophilia. For example， with only a heterozygous factor V LeICen would not receive prophylaxis during her pregnancy， she would only receive it during the postpartum period， but if she had an anti-thrombin deficiency or has a combination of risk factors such as obesity or complicated pregnancies， these women may receive thromboprophylaxis. The risk is 1 or 2 per 1，000 pregnancies. This is quite significant.
    Le Gal：对于DVT的一级预防，我们确定的是如果女性过去发生过与妊娠或口服避孕药相关的DVT，那么在妊娠全程需要使用预防性低分子肝素治疗，从第6周开始到产后。如果发生的是原因不明的DVT或PE，处理方法也一样。另一方面，如果DVT或PE明确是由于外科手术或其他原因引起的，那么在妊娠期通常就不需要接受预防性抗凝治疗，只需要在产后使用低分子肝素。如果没有DVT病史，那么在妊娠期需要预防性抗凝的概率就非常小，除非有高危血栓形成倾向。例如，杂合型V因子LeICen突变的患者不需要妊娠期预防性抗凝治疗，只需要产后抗凝。而如果存在抗凝血功能障碍或合并几种危险因素如肥胖或复杂妊娠，那么就抗凝需要接受预防血栓的治疗。血栓风险是每1000次妊娠1～2例。这很重要。
　International Circulation: What were some of your opinions of the meeting in Vienna? What were some of the interesting topics discussed?
　《国际循环》:您对维也纳会议有什么看法？会议讨论了哪些有趣的主题？
    Dr. Le Gal: There were a lot of presentations. There was an interesting trial presented on whether low-molecular weight heparin prevents recurrent pregnancy loss in thrombophilic women. This trial was negative， with no difference in terms of pregnancy loss. More studies are ongoing and we await their results. This meeting is always interesting because unfortunately， in pregnant women， there is not a lot of clinical evICence. This meeting allows clinical experts from around the world to share their experience in how they deal with these kinds of issues to compare the attitudes and come to a consensus in how we management these patients.
　Le Gal：会议上有很多报告。有一个引人关注的试验是关于是否低分子肝素能够预防有血栓形成倾向女性的反复流产。试验结果是阴性的，在流产方面没有差异。很多研究正在进行，我们在等待它们的结果。会议总是很引人关注，因为对于孕妇的临床证据不多。这个会议让世界各地的临床专家能够分享治疗这些患者的经验，交流看法并达成共识。