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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
Published on: February 10, 2023
Venous thromboembolism in pregnancy
1University of Toronto, Women's College Hospital, Department of Medicine, Toronto, ON, M5S 1B2, Canada. wee-shian.chan@wchospital.ca
Expert Review of Cardiovascular Therapy
|November 27, 2010
Summary
Pregnancy increases the risk of venous thromboembolism (VTE). Early diagnosis and prevention are crucial due to severe consequences, though risk factors and optimal prophylaxis strategies require further definition.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Vascular Medicine
Background:
- Pregnancy significantly elevates the risk of venous thromboembolism (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE).
- Despite the low absolute risk, VTE in pregnancy poses severe maternal and fetal health risks, necessitating clinical vigilance.
- Current diagnostic methods for VTE in pregnancy are primarily based on non-pregnant patient data, highlighting a need for pregnancy-specific insights.
Purpose of the Study:
- To review current understanding of VTE risk factors during pregnancy.
- To discuss the diagnostic challenges and evolving insights into VTE in pregnant individuals.
- To emphasize the importance of vigilance for VTE, including in unusual sites, especially with assisted reproductive techniques.
Main Methods:
- Review of existing literature and recent studies on venous thromboembolism in pregnancy.
- Analysis of risk factors, including inherent patient factors, pregnancy-associated factors, and delivery methods.
- Consideration of diagnostic criteria and emerging data for VTE in pregnant populations.
Main Results:
- VTE development in pregnancy is multifactorial, influenced by patient-specific, pregnancy-specific, and delivery-related factors.
- The precise risk stratification for individual factors and combinations, guiding thromboprophylaxis, remains undefined.
- Increased use of assisted reproductive techniques is associated with VTE risk, even in early pregnancy and unusual locations.
Conclusions:
- Enhanced vigilance for VTE during pregnancy is essential due to potential severe outcomes.
- Further research is needed to define optimal risk assessment and thromboprophylaxis strategies in pregnancy.
- Clinicians should be aware of VTE in early pregnancy and atypical presentations, particularly in women conceiving via assisted reproductive techniques.
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