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Individual risk assessment of thrombosis in pregnancy
Pelle G Lindqvist1, Marius Kublikas, Björn Dahlbäck
1Department of Obstetrics and Gynecology, Lund University, University Hospital, Malmö, Sweden. Pelle.Lindqvist@obst.mas.lu.se
Background:
Thromboembolic complications during pregnancy are major contributors to maternal death, but there is no reliable way to estimate the absolute risk of thrombosis before the occurrence of a thromboembolic complication.
Objective:
To create a model for individual estimation of thrombosis risk during pregnancy and to determine the distribution of risk estimates in a series of gravidae.
Method And Patients:
Estimates of absolute risk of pregnancy-related thromboembolism were calculated by multiplying reported figures of thrombosis incidence by prevalence-adjusted odds ratios of the following variables: smoking, parity, preeclampsia, mode of delivery, age, overweight, activated protein C resistance (FV Leiden or FV:Q506), thrombosis heredity, and previous thrombosis. We present the risk distribution among a unselected prospectively gathered cohort of 2384 unselected gravidae who were interviewed and tested for activated protein C resistance in early pregnancy.
Results And Conclusions:
A model for individual estimation of the absolute risk of thrombosis is presented, which is provided to the readers as a free automatic Internet-based service (http://www.riskpreg.com). As compared with antepartum, more women at high risk can be identified in the postpartum period and we suggest that this might be of use in planning the prevention of thrombosis.