Thromboembolism in pregnancy: recurrence risks, prevention and management.
OBJECTIVE
The purpose of this review is to summarize the epidemiology of thromboembolism in pregnancy and describe strategies to prevent and treat it.


RESULTS
The main reason for the increased risk of thrombosis in pregnancy is hypercoagulability. Other risk factors include a history of thrombosis, inherited and acquired thrombophilia, certain medical conditions, and complications of pregnancy and childbirth.


CONCLUSIONS
The hypercoagulability of pregnancy is present as early as the first trimester and so is the increased risk of thrombosis. Candidates for anticoagulation are women with a current thrombosis, a history of thrombosis, thrombophilia and a history of poor pregnancy outcome, or risk factors for postpartum thrombosis. For fetal reasons, the preferred agents for anticoagulation in pregnancy are heparins. There are no large trials of anticoagulants in pregnancy and recommendations are based on case series and the opinion of experts. Nonetheless, anticoagulants are believed to improve the outcome of pregnancy for women and their fetuses.
James
Andra H
AH
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina 27710, USA. andra.james@duke.edu
D000925:Anticoagulants / Q000627:therapeutic use; D002585:Cesarean Section; D005260:Female; D006801:Humans; D049590:Postpartum Period; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011256:Pregnancy Outcome; D012008:Recurrence; D012306:Risk; D012307:Risk Factors; D013923:Thromboembolism / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy*; D019851:Thrombophilia / Q000150:complications / Q000453:epidemiology; D016896:Treatment Outcome
D000925:Anticoagulants