Thrombosis during pregnancy and the postpartum period.
OBJECTIVE
To describe the circumstances surrounding deep vein thrombosis among pregnant or postpartum patients enrolled in a large multicenter registry.


METHODS
Consecutive patients with ultrasound-confirmed deep vein thrombosis were enrolled at 183 institutions during a 6-month period from October 2001 to March 2002. Fifty-three who were either pregnant or within 6 weeks postpartum were analyzed.


RESULTS
Thirty-four were pregnant and 19 were postpartum. Among those pregnant, 44% experienced deep vein thrombosis in the first trimester, 24% in the second, and 26% in the third. Deep vein thrombosis occurred in the left lower extremity in 76% of the pregnant and 47% of the postpartum women. Four pregnant and 2 postpartum women had pelvic vein thrombosis. Among those postpartum, 74% had undergone surgery within 3 months.


CONCLUSIONS
During pregnancy, the risk of deep vein thrombosis begins in the first trimester. Thus, we believe that when prophylaxis is indicated, it should be initiated early in gestation.
James
Andra H
AH
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710 and Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA. andra.james@duke.edu
Tapson
Victor F
VF
Goldhaber
Samuel Z
SZ
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D007866:Leg / Q000098:blood supply; D010388:Pelvis / Q000098:blood supply; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology / Q000209:etiology; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D011644:Puerperal Disorders / Q000453:epidemiology / Q000209:etiology; D012042:Registries; D012307:Risk Factors; D013923:Thromboembolism / Q000517:prevention & control; D019851:Thrombophilia / Q000453:epidemiology; D013927:Thrombosis / Q000453:epidemiology / Q000209:etiology; D014680:Veins; D020246:Venous Thrombosis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control
D000925:Anticoagulants; D006493:Heparin