Deep-vein thrombosis in pregnancy. A case report

Area of Science:

• Obstetrics and Gynecology
• Hematology
• Vascular Medicine

Background:

• Thrombo-embolic complications, including deep-vein thrombosis (DVT), occur in 2-5 per 1000 pregnancies.
• DVT is a significant contributor to maternal morbidity and mortality, often linked to pulmonary embolism and chronic venous insufficiency.

Observation:

• Diagnostic methods for iliofemoral or calf vein thrombosis include Doppler ultrasonography, impedance plethysmography, and ascending phlebography.
• Acute DVT and pulmonary embolism during pregnancy or the puerperium are treated with full-dose intravenous heparin for 5-10 days.
• Long-term management with low-dose subcutaneous heparin is effective and feasible.
• Coumarin is contraindicated during pregnancy due to teratogenic effects (embryopathy) from placental transfer.

Findings:

• Low-dosage intravenous or subcutaneous heparin is a safe and effective anticoagulant for pregnant individuals.
• Heparin is the preferred anticoagulant over coumarin during pregnancy and the puerperium.

Implications:

• Optimized anticoagulant therapy during pregnancy can reduce maternal morbidity and mortality associated with thrombo-embolic events.
• Establishing safe and effective anticoagulant protocols is crucial for managing pregnant patients with venous thromboembolism.
• Further research into long-term anticoagulation strategies in pregnancy may improve patient outcomes.