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Thrombosis during pregnancy and the postpartum period
Andra H James1, Victor F Tapson, Samuel Z Goldhaber
1Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710 and Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA. andra.james@duke.edu
Objective:
To describe the circumstances surrounding deep vein thrombosis among pregnant or postpartum patients enrolled in a large multicenter registry.
Study Design:
Consecutive patients with ultrasound-confirmed deep vein thrombosis were enrolled at 183 institutions during a 6-month period from October 2001 to March 2002. Fifty-three who were either pregnant or within 6 weeks postpartum were analyzed.
Results:
Thirty-four were pregnant and 19 were postpartum. Among those pregnant, 44% experienced deep vein thrombosis in the first trimester, 24% in the second, and 26% in the third. Deep vein thrombosis occurred in the left lower extremity in 76% of the pregnant and 47% of the postpartum women. Four pregnant and 2 postpartum women had pelvic vein thrombosis. Among those postpartum, 74% had undergone surgery within 3 months.
Conclusion:
During pregnancy, the risk of deep vein thrombosis begins in the first trimester. Thus, we believe that when prophylaxis is indicated, it should be initiated early in gestation.
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