Pregnancy, thrombophlebitis and thromboembolism: what every obstetrician should know.
Thrombophlebitis is caused by superficial venous thrombosis and vascular inflammatory changes affecting the lower limbs. The condition is often encountered in pregnancy and symptomatic treatment including compression and analgesia are commonly employed. The obstetrician may become involved in the management of thrombophlebitis; however the potential for embolic complications, and need for adequate assessment remain widely unrecognised. This case report highlights pitfalls in the management of thrombophlebitis, in particular the dangers of clinical assessment without the use of Doppler ultrasound and the potential for deep venous extension and embolic complications. The case also documents the use of low molecular-weight heparin in pregnancy to prevent such complications and promote thrombus resolution; a review of the available treatment options, including surgery, is included. Whilst thromboembolism remains a leading cause of maternal death, the potential dangers of symptomatic thrombophlebitis should not be overlooked.
Kupelian
A S
AS
Department of Obstetrics and Gynaecology, Stepping Hill Hospital, Manchester, UK. anthonyskupelian@hotmail.com
Huda
M S B
MS
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control; D013924:Thrombophlebitis / Q000150:complications / Q000188:drug therapy*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight