Pregnancy and deep vein thrombosis.
The diagnosis, treatment, and prevention of deep vein thrombosis (DVT) during pregnancy remain problematic. This article reviews the pathophysiology of pregnancy-related DVT and suggests diagnostic strategies, highlighting the pitfalls specific to this patient population. The treatment of DVT in pregnant patients is difficult because unfractionated heparin and low-molecular-weight heparins, the cornerstones of initial therapy, may have significant maternal side effects and warfarin can cause embryopathy and other adverse fetal effects. As well, there are limited data regarding the efficacy of anticoagulant therapy in the treatment and prophylaxis of DVT during pregnancy. This article briefly reviews the areas of controversy and provides recommendations for the treatment of acute DVT and thromboprophylaxis in pregnant patients.
Bates
S M
SM
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Ginsberg
J S
JS
D000925:Anticoagulants / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D005333:Fetus / Q000528:radiation effects; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006493:Heparin / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D010314:Partial Thromboplastin Time; D010920:Placenta / Q000187:drug effects; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy*; D011256:Pregnancy Outcome; D013923:Thromboembolism / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D016216:Ultrasonography, Prenatal; D020246:Venous Thrombosis / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy*
D000925:Anticoagulants; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D006493:Heparin