Pregnancy and Venous Thromboembolism

Abstract

Pregnancy and the postpartum period are associated with an increased risk of venous thromboembolism (VTE), which complicates 1 to 2 of 1,000 pregnancies and represents a leading cause of mortality during pregnancy in developed countries. Strong evidence for the management of pregnancy-related VTE is missing, mostly because pregnant women have been excluded from all major trials investigating different diagnostic tools and treatment regimens. Nevertheless, proper evaluation of the involved risk factors is mandatory to reduce the incidence of pregnancy-related VTE and improve outcomes. Low-molecular-weight heparins are considered as a first-line option in the management of pregnancy-related VTE. With regard to future research, there is a need for methodologically strong studies in pregnant women, especially with respect to risk stratification, optimal heparin doses, usefulness of anti-FXa levels and their correlation with clinical outcomes, and correct management of anticoagulation during delivery.

Origin and levels of circulating microparticles in normal pregnancy: A longitudinal observation in healthy women

“…fetal growth restriction, abruption, stillbirth and preeclampsia) has been previously described [1,2]. This hypercoagulability can account for the tenfold higher incidence of venous thromboembolism observed during normal pregnancy as compared to non-pregnant women and be responsible for placental thrombosis in gestational vascular complications [3]. Many alterations of the coagulative system, such as the imbalance between pro/anticoagulant factors or vascular dysfunctions (i.e.…”

Point-of-Care Testing in Burn Patients

“…29,30 Hypercoagulability is also an issue in pregnant women due to the increase in procoagulant factors except FXI and a decrease in natural anticoagulants (e.g., protein S). 31 Again, these changes are poorly reflected by CCAs, but have been shown by means of VCAs. 32 The typical VCA trace of a pregnant woman in the third trimester is characterized by an increased MCF/MA indicating this hypercoagulability.…”

Risk Factors for Cerebral Venous Thrombosis

“…35 Pregnancy and puerperium both lead to a change in the coagulation system, which, among other changes, results in an increased fibrin production. 36,37 As a result, the risk of VTE of the legs and lungs, and CVT are enhanced during pregnancy and puerperium. [38][39][40][41] For CVT, the risk appears to be particularly high during puerperium.…”