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Pregnancy-Associated Venous Thromboembolism.

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Venous thromboembolism (VTE) is a major cause of maternal death, with pregnancy increasing VTE risk. This review covers VTE causes, risk factors, and management options during pregnancy.

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Area of Science:

  • Obstetrics and Gynecology
  • Hematology
  • Cardiovascular Medicine

Background:

  • Venous thromboembolism (VTE) is a significant cause of maternal mortality in the U.S.
  • Pregnancy involves physiological changes that increase VTE risk, aligning with Virchow's triad.
  • Additional risk factors include multiple gestations, advanced maternal age, cesarean delivery, and obesity.

Purpose of the Study:

  • To review the prevalence, pathogenesis, and predisposing factors of VTE during pregnancy.
  • To discuss current and emerging therapeutic options for managing VTE in pregnant individuals.

Main Methods:

  • Literature review of studies on pregnancy-associated venous thromboembolism.
  • Analysis of physiological changes and risk factors contributing to VTE in pregnancy.
  • Evaluation of treatment modalities for VTE in the context of maternal-fetal safety.

Main Results:

  • Pregnancy significantly elevates VTE risk due to hypercoagulability, reduced fibrinolysis, and venous stasis.
  • Multiple gestations, advanced maternal age, cesarean delivery, and obesity are key risk factors.
  • Anticoagulant therapy during pregnancy presents challenges regarding maternal and fetal safety.

Conclusions:

  • Understanding VTE pathophysiology and risk factors in pregnancy is crucial for effective management.
  • Therapeutic strategies including systemic thrombolysis, mechanical thrombectomy, and catheter-directed thrombolysis require careful consideration of risks and benefits.
  • Further research is needed to optimize VTE prevention and treatment in pregnant populations.