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6 - Thromboprophylaxis and treatment of thrombosis in pregnancy

Published online by Cambridge University Press:  01 February 2010

By
L. Heilmann ,
W. Rath  and
R. L. Bick
Edited by
Rodger L. Bick ,
Eugene P. Frenkel ,
William F. Baker  and
Ravi Sarode
L. Heilmann
Affiliation:
Professor of Obstetrics and Gynaecology, City Hospital, Rüsselsheim
W. Rath
Affiliation:
Professor of Obstetrics and Gynaecology, University of Aachen, Aachen, Germany
R. L. Bick
Affiliation:
Clinical Professor of Medicine and Pathology, University of Texas Southwestern Medical Center; Director: Dallas
Rodger L. Bick
Affiliation:
University of Texas Southwestern Medical Center, Dallas
Eugene P. Frenkel
Affiliation:
University of Texas Southwestern Medical Center, Dallas
William F. Baker
Affiliation:
University of California, Los Angeles
Ravi Sarode
Affiliation:
University of Texas Southwestern Medical Center, Dallas
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Summary

Introduction

The true incidence of thromboembolic complications in pregnancy and the distribution of these events between the antenatal and postnatal periods are unknown. Early studies have estimated an incidence of symptomatic venous thrombosis during pregnancy using radiographic investigations between 0.5 and 3.0 per 1,000 deliveries. Lindqvist et al. used the Swedish national registries of births to investigate the number of objectively confirmed DVT between 1990 and 1993. The overall incidence of venous thromboembolic events was 1.3 per 1,000 deliveries in contrast to McColl et al. with 0.8 per 1,000 deliveries, Gherman et al. with 0.6 per 1,000 deliveries and Simpson et al. with 0.85 per 1,000 deliveries. More recent studies have demonstrated that antepartum deep vein thrombosis (DVT) is at least as common as postpartum DVT (Fig. 6.1) and can occur at any time during gestation, although pulmonary emboli (PE) remains more common postpartum. Earlier postpartum ambulation and discharge of patients from the hospital may have resulted in a relative decrease in postpartum events as compared to antepartum period, but the daily risk of thromboembolic complication was therefore highest in the postpartum period.

In a retrospective study McColl et al. described an incidence of DVT at 0.5 per 1,000 deliveries in the antenatal period and 0.21 in the puerperium. The incidence of pulmonary embolism was 0.07 per 1,000 deliveries and 0.08 in the puerperium respectively.

Type
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Information
Hematological Complications in Obstetrics, Pregnancy, and Gynecology , pp. 200 - 221
Publisher: Cambridge University Press
Print publication year: 2006

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  • Thromboprophylaxis and treatment of thrombosis in pregnancy
    • By L. Heilmann, Professor of Obstetrics and Gynaecology, City Hospital, Rüsselsheim, W. Rath, Professor of Obstetrics and Gynaecology, University of Aachen, Aachen, Germany, R. L. Bick, Clinical Professor of Medicine and Pathology, University of Texas Southwestern Medical Center; Director: Dallas
  • Edited by Rodger L. Bick, University of Texas Southwestern Medical Center, Dallas, Eugene P. Frenkel, University of Texas Southwestern Medical Center, Dallas, William F. Baker, University of California, Los Angeles, Ravi Sarode, University of Texas Southwestern Medical Center, Dallas
  • Book: Hematological Complications in Obstetrics, Pregnancy, and Gynecology
  • Online publication: 01 February 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511526978.007
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  • Thromboprophylaxis and treatment of thrombosis in pregnancy
    • By L. Heilmann, Professor of Obstetrics and Gynaecology, City Hospital, Rüsselsheim, W. Rath, Professor of Obstetrics and Gynaecology, University of Aachen, Aachen, Germany, R. L. Bick, Clinical Professor of Medicine and Pathology, University of Texas Southwestern Medical Center; Director: Dallas
  • Edited by Rodger L. Bick, University of Texas Southwestern Medical Center, Dallas, Eugene P. Frenkel, University of Texas Southwestern Medical Center, Dallas, William F. Baker, University of California, Los Angeles, Ravi Sarode, University of Texas Southwestern Medical Center, Dallas
  • Book: Hematological Complications in Obstetrics, Pregnancy, and Gynecology
  • Online publication: 01 February 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511526978.007
Available formats
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  • Thromboprophylaxis and treatment of thrombosis in pregnancy
    • By L. Heilmann, Professor of Obstetrics and Gynaecology, City Hospital, Rüsselsheim, W. Rath, Professor of Obstetrics and Gynaecology, University of Aachen, Aachen, Germany, R. L. Bick, Clinical Professor of Medicine and Pathology, University of Texas Southwestern Medical Center; Director: Dallas
  • Edited by Rodger L. Bick, University of Texas Southwestern Medical Center, Dallas, Eugene P. Frenkel, University of Texas Southwestern Medical Center, Dallas, William F. Baker, University of California, Los Angeles, Ravi Sarode, University of Texas Southwestern Medical Center, Dallas
  • Book: Hematological Complications in Obstetrics, Pregnancy, and Gynecology
  • Online publication: 01 February 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511526978.007
Available formats
×