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Pulmonary embolism during and after pregnancy
Sarah E Stone1, Timothy A Morris
1Department of Medicine, University of California, San Diego, San Diego, CA, USA.
Critical Care Medicine
|October 11, 2005
Summary
Diagnosing and treating venous thromboembolic disease during pregnancy requires objective testing and heparin anticoagulation. While safe during pregnancy, warfarin is typically reserved for postpartum use.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Cardiology
Background:
- Venous thromboembolic disease (VTE) is a leading cause of pregnancy complications.
- Clinical assessment for VTE is challenging in pregnant patients.
Purpose of the Study:
- To review diagnostic and treatment strategies for VTE in pregnancy.
- To highlight the safety and efficacy of various VTE interventions during gestation.
Main Methods:
- Review of objective diagnostic tests for VTE, including ultrasound, V/Q scans, CT, and angiography.
- Discussion of anticoagulation therapies, including heparin and warfarin.
- Consideration of treatments for unstable pulmonary embolism.
Main Results:
- Objective tests for VTE are safe and essential during pregnancy.
- Heparin (unfractionated and low molecular weight) is the preferred anticoagulation during pregnancy.
- Warfarin is generally avoided due to fetal risks but can be used postpartum.
Conclusions:
- VTE poses a significant risk during pregnancy and postpartum.
- Timely diagnosis via objective testing is crucial.
- Heparin-based anticoagulation is the standard of care for VTE in pregnancy.