Venous thromboembolism during pregnancy

Lee T. Dresang, Pat Fontaine, Larry Leeman, Valerie J. King

Research output: Contribution to journalReview article

21 Scopus citations

Abstract

Venous thromboembolism is the leading cause of maternal death in the United States. Pregnancy is a risk factor for deep venous thrombosis, and risk is further increased with a personal or family history of thrombosis or thrombophilia. Screening for thrombophilia is not recommended for the general population; however, testing for inherited or acquired thrombophilic conditions is recommended when personal or family history suggests increased risk. Factor V Leiden and prothrombin G20210A mutation are the most common inherited thrombophilias, and antiphospholipid antibody syndrome is the most important acquired defect. Clinical symptoms of deep venous thrombosis may be subtle and difficult to distinguish from gestational edema. Venous compression (Doppler) ultrasonography is the diagnostic test of choice. Pulmonary embolism typically presents postpartum with dyspnea and tachypnea. Multidetector-row (spiral) computed tomography is the test of choice for pulmonary embolism. Warfarin is contraindicated during pregnancy, but is safe to use postpartum and is compatible with breastfeeding. Low-molecular-weight heparin has largely replaced unfractionated heparin for prophylaxis and treatment in pregnancy.

Original languageEnglish (US)
Pages (from-to)1709-1716
Number of pages8
JournalAmerican family physician
Volume77
Issue number12
StatePublished - Jun 15 2008

ASJC Scopus subject areas

  • Family Practice

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    Dresang, L. T., Fontaine, P., Leeman, L., & King, V. J. (2008). Venous thromboembolism during pregnancy. American family physician, 77(12), 1709-1716.