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Pregnancy-Associated Venous Thromboembolism.
Omar Seyam1, William H Frishman2, Wilbert S Aronow2
1From the Department of Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, FL.
Cardiology in Review
|April 26, 2024
Summary
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.
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.
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