Guidelines for the management of cerebral venous thrombosis during pregnancy and the puerperium (2025 edition)

Maternal and infant mortality rates are important indicators for evaluating the level of healthcare services in a country or a region. Due to physiological and internal environmental changes, women during pregnancy and the puerperium are at an increased risk of developing cerebral venous thrombosis (CVT). CVT occurring during pregnancy and the puerperium poses significant risks to both maternal and neonatal health. However, due to its hidden onset, non-specific clinical signs, and symptoms that overlap with normal perinatal changes, many clinicians lack adequate awareness and attention of it. To address this issue, the Expert Committee of the National Health Commission's Million Disability Reduction Project, together with the Cerebral Venous Disease Group of the Chinese Stroke Association and the Stroke Prevention and Control Professional Committee of the Chinese Preventive Medicine Association, convened leading experts from relevant fields across China to developed the "Guidelines for the management of cerebral venous thrombosis during pregnancy and the puerperium (2025 edition)" using the Delphi method on the basis of the latest domestic and international progress. These guidelines encompass eight aspects: epidemiology, pathogenesis and risk factors, clinical presentation, diagnosis and differential diagnosis, treatment, pregnancy and lactation, prevention strategies, and management of future pregnancies of CVT during pregnancy and postpartum period. A total of 49 recommendations are provided, aiming to establish a standardized and China-specific management framework for CVT during pregnancy and puerperium, and promote homogenized development of prevention and treatment capabilities across medical institutions at all levels.

孕产妇和婴儿死亡率是评价国家或区域医疗服务水平的重要指标。由于生理状态和内环境的改变，妊娠期和产褥期女性是脑静脉血栓形成（CVT）的高危人群。妊娠期和产褥期CVT严重危害母婴健康，然而因其起病隐匿、临床表现缺乏特异性以及妊娠和产褥期本身的一系列症状干扰，部分临床医师对其认知和重视不足。为此，国家卫生健康委百万减残工程专家委员会、中国卒中学会脑静脉病变分会、中华预防医学会卒中预防与控制专业委员会组织我国相关领域的专家学者，结合国内外最新进展，通过德尔菲法论证制订了《妊娠期和产褥期脑静脉血栓形成管理指南（2025版）》。本指南涵盖妊娠期和产褥期CVT的流行病学、发病机制和风险因素、临床表现、诊断和鉴别诊断、治疗、妊娠和哺乳、预防及再次妊娠的管理等8个方面内容，共提出49条推荐意见，旨在构建符合我国国情的妊娠期和产褥期CVT规范化管理体系，推动各级医疗机构在该领域防治能力的同质化发展。.