Venous thromboembolism in pregnant woman — a challenge for the clinician
Deep vein thrombosis and pulmonary embolism are two clinical entities of a single disease called venous thromboembolism. Venous thromboembolism is an important cause of maternal morbidity and mortality. Diagnosis and treatment of venous thromboembolism in pregnant women are much more difficult than in non-pregnant women. Pregnant patients were excluded from all major clinical trials investigating therapeutic combinations for acute thromboembolism. Although, for many years, the standard anticoagulant during pregnancy and postpartum was unfractionated heparin, current guidelines recommend low molecular weight heparin. The advantages of low molecular weight heparin are lower risk of bleeding, predictable pharmacokinetics, lower risk of fracture because of thrombocytopenia and heparin-induced osteoporosis.
KeywordsThromboembolism Pregnancy Anticoagulation
Unable to display preview. Download preview PDF.
- Centre for Maternal and Child Enquiries (CMACE). Saving Mothers’ Lives. Reviewing maternal deaths to make motherhood safer: 2006–2008. BJOG 2011; 118(Suppl.), 1–203Google Scholar
- EUROPERISTAT Project, SCPE EUROCAT, EURONEOSTAT. European perinatal health report. http://www.europeristat.com/publications/european-perinatal-health-report.shtml
- American College of Obstetricians and Gynecologists. Thromboembolism in pregnancy. ACOG Practice Bulletin No. 19. Obstet Gynecol. 2000; 96(2): 1–10Google Scholar
- Qaseem A, Snow V, Barry P, et al, for the Joint American Academy of Family Physicians/American College of Physicians Panel on Deep Venous Thrombosis/Pulmonary Embolism. Current diagnosis of venous thromboembolism in primary care: a clinical practice guideline from the American Academy of Family Physicians and the American College of Physicians. Ann Intern Med. 2007; 146(6): 454–458PubMedCrossRefGoogle Scholar
- Michiels JJ, Freyburger G, van der Graaf F, Janssen M, Oortwijn W, Van Beek E. Strategies for the safe and effective exclusion and diagnosis of deep vein thrombosis by the sequential use of clinical score, D-dimer testing, and compression ultrasonography. Semin Thromb Hemost. 2000; 26(6): 657–667PubMedCrossRefGoogle Scholar