Pregnancy-related venous thromboembolism: risk and the effect of thromboprophylaxis |
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| Authors: | Lussana Federico Coppens Michiel Cattaneo Marco Middeldorp Saskia |
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| Affiliation: | a Divisione di Medicina Generale III, Azienda Ospedaliera San Paolo Dipartimento di Medicina, Chirurgia e Odontoiatria, Università degli Studi di Milano, Italyb Department of Vascular Medicine, Academic Medical Center, Amsterdam, Amsterdam, The Netherlands |
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| Abstract: | Venous thromboembolism (VTE) is a leading cause of maternal mortality and morbidity during pregnancy in developed countries. The incidence of VTE per pregnancy-year increases about 4-fold during pregnancy and at least 14-fold during the puerperium. Risk factors include a personal history of VTE, presence of inherited or acquired thrombophilia, a family history of VTE and general medical conditions, such as immobilisation, overweight, varicose veins, some haematological diseases and inflammatory disorders. VTE is considered potentially preventable with the prophylactic administration of anticoagulants, but there are no high quality randomized clinical trials that compared different strategies of thromboprophylaxis in pregnant women. Balancing the absolute risk of VTE against the risks of exposure to anticoagulants, this review provides advice regarding which women may benefit from thromboprophylaxis during and after pregnancy. |
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| Keywords: | VTE, venous thromboembolism DVT, deep vein thrombosis PE, pulmonary embolism FV Leiden, factor V Leiden APLA, antiphospholipid antibody APS, antiphospholipid syndrome HIT, heparin-induced thrombocytopenia UFH, unfractionated heparin LMWH, low-molecular-weight heparin VKA, Vitamin K antagonists ACCP, American College of Chest Physicians SISET, Italian Society for Haemostasis and Thrombosis OR, Odds Ratios CI, Confidence Intervals |
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