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[Maternal death by venous thromboembolic disease]
M Rossignol1, E Morau2, M Dreyfus3
1Département d'anesthésie-réanimation-SMUR, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, 2, rue Ambroise-Paré, 75010 Paris, France.
Gynecologie, Obstetrique, Fertilite & Senologie
|November 25, 2017
Summary
Pregnancy and postpartum increase the risk of venous thromboembolism (VTE) events, a leading cause of maternal death. Many VTE deaths are preventable with timely diagnosis and appropriate anticoagulation treatment.
Area of Science:
- Obstetrics and Gynecology
- Cardiology
- Maternal Health
Background:
- Pregnancy and the postpartum period are high-risk times for venous thromboembolism (VTE) events.
- Pulmonary embolism (PE) is a significant cause of direct maternal mortality in Western countries.
Observation:
- Between 2010-2012 in France, 24 deaths were attributed to PE, with 54% occurring postpartum.
- A notable 50% of these maternal deaths were deemed avoidable.
- Key avoidability factors included diagnostic delays and inadequate anticoagulation therapy.
Findings:
- Effective anticoagulation for suspected VTE should be initiated promptly.
- Low molecular weight heparin dosage must be adjusted for patient weight, especially in cases of obesity.
- CT pulmonary angiography is not contraindicated in pregnant women for diagnosing PE.
Implications:
- Optimizing VTE diagnosis and management during pregnancy and postpartum is crucial for reducing maternal mortality.
- Tailoring anticoagulation protocols to individual patient factors, like weight and renal function, is essential.
- Clinical vigilance and timely intervention can significantly improve outcomes for pregnant and postpartum women at risk for VTE.
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