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DVT and Pregnancy

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Principles of Critical Care in Obstetrics

Abstract

Pregnancy and the postpartum period are associated with an increased risk of venous thromboembolism (VTE), which complicates 1–2 of 1000–20,000 pregnancies and represents a leading cause of mortality during pregnancy. Strong evidence for the management of pregnancy-related DVT is missing. Different diagnostic tools and treatment regimens are described, but are not adequate especially in resource-poor settings. Nevertheless, proper evaluation of involved risk factors is mandatory in order to reduce the incidence of pregnancy-related DVT and improve outcomes. The clinical awareness of DVT in pregnancy and its timely management help to prevent the dreadful complication, that of pulmonary embolism. Thrombosis and thromboembolism was the leading cause of maternal deaths during 2010–2012 in the UK, occurring in 1.08 in 100,000 maternities. Low-molecular-weight heparins are considered the first-line option in the management of pregnancy-related VTE. Continuation of therapy into the postpartum period is mandatory in proven cases of DVT. Labor management methods of women who are anticoagulated are also essential. Stronger evidences in pregnant women, especially with respect to risk stratification, optimal heparin doses, and correct management of anticoagulation during delivery and postpartum, are essential in managing this condition. A national registry for reporting each case of VTE would add on to improving the quality of health care.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Vijayalakshmi Medical Centre, NH-Bypass, Vennala P.O., Kochi, Kerala, India

    Vijayalakshmi G. Pillai DGO, MRCOG

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  1. Vijayalakshmi G. Pillai DGO, MRCOG
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Correspondence to Vijayalakshmi G. Pillai DGO, MRCOG .

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Editors and Affiliations

  1. Arihant Women’s Hospital, Ahmedabad, Gujarat, India

    Alpesh Gandhi

  2. Rainbow Healthcare, Agra, India

    Narendra Malhotra

  3. Art Rainbow-IVF, Agra, India

    Jaideep Malhotra

  4. Obstetrics and Gynecology, SN Medical College, Agra, India

    Nidhi Gupta

  5. Bharti Vidya Peethmedical College, Pune, India

    Neharika Malhotra Bora

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Pillai, V.G. (2016). DVT and Pregnancy. In: Gandhi, A., Malhotra, N., Malhotra, J., Gupta, N., Bora, N. (eds) Principles of Critical Care in Obstetrics. Springer, New Delhi. https://doi.org/10.1007/978-81-322-2686-4_20

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