Retrievable Inferior vena cava filters in pregnancy: Risk versus benefit?

Crosby, David; Ryan, Kevin M.; McEniff, Niall; Regan, Carmen; Lynch, Catherine; Byrne, Bridgette

doi:10.1016/j.ejogrb.2017.12.035

Cited by 17 publications

(18 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Examining the maternal factors in this case, VTE disease is known to affect women in pregnancy and the puerperium approximately 10 times more frequently when compared to an age-matched non-pregnant cohort of women [13]. The treatment of recurrent VTE disease in pregnancy is complex and debated, with some authors recommending retrievable filters over permanent filters given the age profile of the pregnant woman coupled with limited available follow-up data for this cohort [14]. Given the paucity of research in this area, treatment is still largely experimental and needs further investigation, potentially in the setting of a randomised controlled trial; however both the feasibility and ethical acceptability of this would make this difficult.…”

Section: Discussionmentioning

confidence: 99%

A double dilemma: treatment of stage IV fetal twin-twin transfusion syndrome in the setting of maternal recurrent venous thromoembolism: a case report

McCarthy

al-Madhani

Smyth

et al. 2019

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

BackgroundFetal conditions can pose significant challenges in the management of pregnancies complicated by pre-existing maternal medical conditions.Case presentationWe report a case of a 34-year-old woman with Stage IV Twin Twin Transfusion syndrome in the presence of maternal recurrent complex venous thromboembolic disease. Following a previous pregnancy loss, complicated by a third episode of thromboembolic disease, an inferior vena cava filter was placed. One month later, a pregnancy was confirmed and subsequently identified as a monochorionic twin pregnancy. Twin-Twin Transfusion syndrome was identified at 18 weeks’ gestation and progressed rapidly to Quintero Stage IV. In consultation with a multi-disciplinary international team, fetoscopic laser photocoagulation was performed. The pregnancy progressed to delivery of female infants at 33 weeks gestation, who have achieved all developmental milestones at 2 years of age.ConclusionsWe describe the multi-disciplinary effort to optimise the maternal condition to allow fetoscopic laser photocoagulation and continued management of the maternal and fetal conditions to a successful pregnancy outcome.

show abstract

Section: Discussionmentioning

confidence: 99%

A double dilemma: treatment of stage IV fetal twin-twin transfusion syndrome in the setting of maternal recurrent venous thromoembolism: a case report

McCarthy

al-Madhani

Smyth

et al. 2019

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

show abstract

“…20,141,142,144,145 Experience with the use of inferior vena cava filters during pregnancy is limited. 164,165 There are concerns that the risk of filter migration, vena cava perforation, and failure of retrieval may be increased in this patient population, 164 although some report a similar risk of complications as in the nonpregnant population. 165 Retrievable filters are preferred in this population.…”

Section: Populationmentioning

confidence: 99%

Pulmonary Embolism in Pregnancy

Bates

2021

Semin Respir Crit Care Med

View full text Add to dashboard Cite

Even though venous thromboembolism is a leading cause of maternal mortality in high-income countries, there are limited high-quality data to assist clinicians with the management of pulmonary embolism in this patient population. Diagnosis, prevention, and treatment of pregnancy-associated pulmonary embolism are complicated by the need to consider fetal, as well as maternal, well-being. Recent studies suggest that clinical prediction rules and D-dimer testing can reduce the need for diagnostic imaging in a subset of patients. Low-molecular-weight heparin is the preferred anticoagulant for both prophylaxis and treatment in this setting. Direct oral anticoagulants are contraindicated during pregnancy and in breastfeeding women. Thrombolysis or embolectomy should be considered for pregnant women with pulmonary embolism complicated by hemodynamic instability. Treatment of pregnancy-associated pulmonary embolism should be continued for at least 3 months, including 6 weeks postpartum. Management of anticoagulants at the time of delivery should involve a multidisciplinary individualized approach that uses shared decision making to take patient and caregiver values and preferences into account.

show abstract

“…[1][2][3]5 If indicated, guidelines recommend the use of temporary retrievable IVC filters that are designed and intended to be removed after a short period of time, over the use of permanent non-retrievable filters. 4 Complications of IVC filters have been reported in 7-22% of the non-pregnant population 6,7 and in 9-42% of patients who had an IVC filter inserted during pregnancy. [7][8][9] Acute complications after IVC filter insertion include access site thrombosis (i.e.…”

Section: Introductionmentioning

confidence: 99%

“…4 Complications of IVC filters have been reported in 7-22% of the non-pregnant population 6,7 and in 9-42% of patients who had an IVC filter inserted during pregnancy. [7][8][9] Acute complications after IVC filter insertion include access site thrombosis (i.e. iliac vein thrombosis), infection, bleeding and perforation.…”

Section: Introductionmentioning

confidence: 99%

“…2,11 These complications are mostly associated with longer indwelling times and remain often asymptomatic but contribute to decreased efficacy of the IVC filter and failure of retrieval with temporary filters. 2,10 Retrieval failure was reported in 11-12% of non-pregnant 7,12 and in 8-26% of pregnant patients [7][8][9] , with higher failure rates for prolonged time to first removal attempt. Due to the risk of these adverse events, insertion of an IVC filter should be considered with prudence and temporary IVC filters should be retrieved as soon as possible.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pregnancy in women with an inferior vena cava filter: a tertiary center experience and overview of the literature

Bistervels¹,

Geerlings²,

Bonta³

et al. 2021

Blood Advances

View full text Add to dashboard Cite

Background: Patients with an inferior vena cava (IVC) filter that remains in situ encounter a lifelong increased risk of deep vein thrombosis and IVC filter complications including fracture, perforation and IVC filter thrombotic occlusion. Data on the safety of becoming pregnant with an in situ IVC filter are scarce. Objective: To evaluate the risk of complications of in situ IVC filters during pregnancy. Methods: We performed a retrospective cohort study of pregnant patients with an in situ IVC filter from a tertiary center between 2000 and 2020. We collected data on complications of IVC filters and pregnancy outcomes. Additionally, we performed a systematic literature search in MEDLINE, Embase and grey literature. Findings: We identified seven pregnancies in four patients with in situ IVC filters with a mean time since IVC filter insertion of 3 years (range 1-8). No complications of IVC filter occurred during pregnancy. Review of literature yielded five studies including 13 pregnancies in nine patients. In one pregnancy a pre-existent, until then asymptomatic, chronic perforation of the vena cava wall by the IVC filter caused major bleeding and uterine trauma with fetal loss. Overall, the complication rate was 5%. Conclusion: It seems safe to become pregnant with an indwelling IVC filter that is intact and does not show signs of perforation, but due to the low number of cases no firm conclusions about safety of in situ IVC filters during pregnancy can be drawn. We suggest imaging prior to pregnancy to reveal asymptomatic IVC filter complications.

show abstract

Retrievable Inferior vena cava filters in pregnancy: Risk versus benefit?

Cited by 17 publications

References 29 publications

A double dilemma: treatment of stage IV fetal twin-twin transfusion syndrome in the setting of maternal recurrent venous thromoembolism: a case report

A double dilemma: treatment of stage IV fetal twin-twin transfusion syndrome in the setting of maternal recurrent venous thromoembolism: a case report

Pulmonary Embolism in Pregnancy

Pregnancy in women with an inferior vena cava filter: a tertiary center experience and overview of the literature

Contact Info

Product

Resources

About