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Thromboembolism in pregnancy: recurrence risks, prevention and management
1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina 27710, USA. andra.james@duke.edu
Current Opinion in Obstetrics & Gynecology
|November 8, 2008
Summary
Pregnancy increases thrombosis risk due to hypercoagulability, starting in the first trimester. Heparins are preferred anticoagulants to improve outcomes for pregnant women and their fetuses.
Area of Science:
- Obstetrics and Gynecology
- Hematology
Background:
- Pregnancy is a hypercoagulable state, increasing the risk of thromboembolism.
- Risk factors include personal/family history of thrombosis, thrombophilia, and pregnancy complications.
Purpose of the Study:
- To review the epidemiology of thromboembolism in pregnancy.
- To outline prevention and treatment strategies for pregnancy-related thrombosis.
Main Methods:
- Literature review of epidemiological data.
- Analysis of risk factors and clinical guidelines for anticoagulation.
Main Results:
- Hypercoagulability and increased thrombosis risk begin in the first trimester.
- Candidates for anticoagulation include those with current/past thrombosis, thrombophilia, or postpartum risk factors.
Conclusions:
- Heparins are the preferred anticoagulants in pregnancy for fetal safety.
- Anticoagulant therapy, though based on limited trials, is believed to improve maternal and fetal outcomes.
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