title: Pregnancy-Related Venous Thromboembolism.
abstract: Pregnancy is associated with an increased risk of venous thromboembolism (VTE), with a reported incidence ranging from 0.49 to 2 events per 1000 deliveries. Risk factors include advanced maternal age, obesity, smoking, and cesarian section. Women with a history of previous VTE are at a 4-fold higher risk of recurrent thromboembolic events during subsequent pregnancies. Additionally, the presence of concomitant thrombophilia, particularly factor V Leiden (homozygosity), prothrombin gene mutation (homozygosity), or antiphospholipid syndrome (APS), increases the risk of pregnancy-related VTE. Low-molecular-weight heparin (LMWH) and unfractionated heparin (UFH) are the drugs of choice for anticoagulation during pregnancy. LMWH is preferred due to ease of use and lower rates of adverse events. Women with high thromboembolic risk particularly those with a family history of VTE should receive antepartum thromboprophylaxis. Women with low thromboembolic risk or previous VTE caused by a transient risk factor (ie, provoked), who have no family history of VTE, may undergo antepartum surveillance. Postpartum anticoagulation can be considered in women with both high and low thromboembolic risk.
authors.affiliation: Department of Pharmacy Practice, Auburn University Harrison School of Pharmacy, Auburn, AL, USA Department of Internal Medicine, University of South Alabama, Mobile, AL, USA ekm0010@auburn.edu.
authors.forename: Emily M
authors.initials: EM
authors.lastname: Armstrong
authors.affiliation: Department of Pharmacy Practice, Concordia University Wisconsin School of Pharmacy, Mequon, WI, USA.
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Bellone
authors.affiliation: Department of Pharmacy Practice, Auburn University Harrison School of Pharmacy, Auburn, AL, USA Midtown Medical Center, Outpatient Clinic, Columbus, GA, USA.
authors.forename: Lori B
authors.initials: LB
authors.lastname: Hornsby
authors.affiliation: Department of Pharmacy Practice, Auburn University Harrison School of Pharmacy, Auburn, AL, USA Department of Family Medicine, University of South Alabama, Mobile, AL, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Treadway
authors.affiliation: Department of Pharmacy Practice, Auburn University Harrison School of Pharmacy, Auburn, AL, USA Family Medicine-Huntsville Campus, University of Alabama School of Medicine, Huntsville, AL, USA.
authors.forename: Haley M
authors.initials: HM
authors.lastname: Phillippe
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D002585:Cesarean Section / Q000009:adverse effects; D005260:Female; D006493:Heparin / Q000009:adverse effects / Q000627:therapeutic use; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008423:Maternal Age; D009765:Obesity / Q000150:complications; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy / Q000517:prevention & control*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D054556:Venous Thromboembolism / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D006493:Heparin
keywords: acquired thrombophilia; inherited thrombophilia; pregnancy; prophylaxis; thrombophilia