Pregnancy and deep vein thrombosis

Area of Science:

• Obstetrics and Gynecology
• Hematology
• Thrombosis Research

Background:

• Deep vein thrombosis (DVT) diagnosis, treatment, and prevention during pregnancy present significant clinical challenges.
• Pregnancy-related DVT pathophysiology requires specific consideration due to unique physiological changes.
• Existing diagnostic strategies have pitfalls when applied to pregnant patients.

Purpose of the Study:

• To review the pathophysiology of pregnancy-related DVT.
• To suggest diagnostic strategies and highlight population-specific pitfalls.
• To provide recommendations for the treatment of acute DVT and thromboprophylaxis in pregnant patients.

Main Methods:

• Literature review of pathophysiology, diagnostic strategies, and treatment options for DVT in pregnancy.
• Analysis of maternal and fetal side effects of anticoagulants (heparin, low-molecular-weight heparin, warfarin).
• Review of controversies and data limitations regarding anticoagulant efficacy in pregnant patients.

Main Results:

• Treatment of DVT in pregnant patients is complicated by potential maternal side effects of unfractionated heparin and low-molecular-weight heparins.
• Warfarin use in pregnancy carries risks of embryopathy and other adverse fetal effects.
• Limited data exist on the efficacy of anticoagulant therapy for DVT treatment and prophylaxis during pregnancy.

Conclusions:

• Management of DVT in pregnancy requires careful consideration of risks and benefits of anticoagulation.
• Further research is needed to establish optimal treatment and prophylaxis protocols.
• Recommendations are provided for managing acute DVT and preventing thrombosis in pregnant individuals.