title: Recurrence of venous thromboembolism in patients with recent gestational deep vein thrombosis or pulmonary embolism: Findings from the RIETE Registry.
abstract: BACKGROUND
  The aim of this study was to investigate the recurrence rate of venous thromboembolism (VTE) and the prevalence of major bleeding or death in patients with previous VTE in pregnancy and puerperium. Risk factors for VTE recurrence were also assessed.
  
  
  METHODS
  We evaluated a cohort of patients enrolled in the international, multicenter, prospective Registro Informatizado de la Enfermedad Trombo-Embólica (RIETE) registry with objectively confirmed VTE.
  
  
  RESULTS
  In the registry, 607 women were presenting with VTE that occurred during pregnancy or puerperium. The 2-year VTE recurrence rate was 3.3% (CI: 95 1.5-5.0%) and the recurrent VTE incidence rate was 2.28events/100 patients-year. Among the 16 cases of VTE recurrence 11 cases appeared during drug treatment while only five cases were diagnosed after therapy discontinuation. No significant difference was found in treatment duration among these two subgroups of VTE recurrence cases and women without recurrence. Furthermore, the use of thrombolytics and inferior vena cava filter in initial treatment was associated to an increased risk of VTE recurrence.
  
  
  CONCLUSIONS
  The current study provides new insights on VTE recurrence rate in patients with deep vein thrombosis (DVT) or pulmonary embolism (PE) that occurred in pregnancy or postpartum period. These findings can contribute to risk assessment of thrombotic burden, thereby allowing for better decision making regarding antithrombotic management in this clinical setting.
authors.affiliation: Center for Haemorrhagic and Thrombotic Disorders, Udine General and University Hospital, Udine, Italy. Electronic address: barillarigiovanni@yahoo.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Barillari
authors.affiliation: Clinic of Obsterics and Gynecology, DISM, University of Udine, Udine, Italy; Unit of Obstetrics and Gynecology, Saint Polo's Hospital, Monfalcone, Italy.
authors.forename: Ambrogio P
authors.initials: AP
authors.lastname: Londero
authors.affiliation: Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Israel; Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Brenner
authors.affiliation: Department of Pneumonology, Hospital Universitario La Fe, Valencia, Spain.
authors.forename: Dolores
authors.initials: D
authors.lastname: Nauffal
authors.affiliation: Department of Internal Medicine, Hospital San Pedro de Alcántara, Cáceres, Spain.
authors.forename: Juan Francisco Sánchez
authors.initials: JF
authors.lastname: Muñoz-Torrero
authors.affiliation: Department of Internal Medicine, Hospital General de Catalunya, Department of Internal Medicine, Clínica del Vallés, Barcelona, Spain.
authors.forename: Fátima
authors.initials: F
authors.lastname: Del Molino
authors.affiliation: Department of Emergency, Clermont-Ferrand University Hospital, Clermont-Ferrand, France.
authors.forename: Farès
authors.initials: F
authors.lastname: Moustafa
authors.affiliation: Department of Internal Medicine, Hospital Infanta Sofía, Madrid, Spain.
authors.forename: Olga
authors.initials: O
authors.lastname: Madridano
authors.affiliation: Department of Internal Medicine, Hospital General Universitario Santa Lucía, Murcia, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Martín-Martos
authors.affiliation: Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Monreal
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006470:Hemorrhage / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D009026:Mortality; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology* / Q000628:therapy; D015995:Prevalence; D011446:Prospective Studies; D011644:Puerperal Disorders / Q000453:epidemiology* / Q000628:therapy; D011655:Pulmonary Embolism / Q000453:epidemiology* / Q000628:therapy; D012008:Recurrence; D012042:Registries; D016306:Vena Cava Filters; D054556:Venous Thromboembolism / Q000453:epidemiology* / Q000628:therapy; D020246:Venous Thrombosis / Q000453:epidemiology* / Q000628:therapy
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents
keywords: Deep-vein thrombosis; Major bleeding; Pregnancy; Puerperium; Pulmonary embolism; Recurrent thromboembolism