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Pregnancy and venous thromboembolism
Eleonora Ralli1, Luigi Zezza, Donatella Caserta
1aDepartment of Obstetrics, Gynecological and Urological Sciences bUnit of Cardiology, Clinical and Molecular Medicine Department, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
Current Opinion in Obstetrics & Gynecology
|October 12, 2014
Summary
This review details the diagnosis and treatment of venous thromboembolism (VTE) in pregnancy, a significant cause of maternal mortality. It synthesizes current guidelines and research to aid clinicians in managing this complex condition safely and effectively.
Area of Science:
- Obstetrics and Gynecology
- Cardiology
- Hematology
Background:
- Venous thromboembolism (VTE) is a leading cause of maternal morbidity and mortality in developed countries, affecting 0.49–2.0 per 1000 deliveries.
- Management of VTE during pregnancy presents unique challenges due to the lack of universal consensus on diagnostic and therapeutic strategies.
- The condition poses a life-threatening risk to both mother and fetus, necessitating careful consideration.
Purpose of the Study:
- To provide a comprehensive overview of diagnostic work-up and treatment for VTE in pregnancy.
- To highlight recent research developments and applicable guidelines for managing VTE during pregnancy and the postpartum period.
- To support multidisciplinary teams, including cardiologists and obstetric/gynecological specialists, in patient management.
Main Methods:
- Review of recent scientific literature and clinical guidelines.
- Analysis of diagnostic options, prophylaxis, and management strategies.
- Synthesis of current knowledge for clinical application.
Main Results:
- VTE incidence during pregnancy and early postpartum ranges from 0.49 to 2.0 per 1000 deliveries.
- Current literature and guidelines are analyzed to inform diagnostic and treatment approaches.
- Emphasis is placed on a case-by-case clinical decision-making process.
Conclusions:
- Despite ongoing debates and a scarcity of high-quality studies, this review simplifies complex aspects of VTE diagnosis and treatment in pregnancy.
- The review aims to balance safety and efficacy in managing this dual life-threatening condition.
- Clinicians are encouraged to apply current knowledge judiciously to reduce pregnancy-related morbidity.
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