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Thromboembolic Disorders
Book chapter   Open access

Thromboembolic Disorders

Audrey A. Merriam and Christian M. Pettker
Queenan's Management of High‐Risk Pregnancy: An Evidence‐Based Approach, pp.123-133
Wiley-Blackwell, Seventh edition
2024
DOI: 10.1002/9781119636540.ch15
url
https://doi.org/10.1002/9781119636540.ch15View
Published (Version of record) Open Access

Abstract

Complicating approximately 1 in 1500 pregnancies, venous thromboembolism is a leading cause of maternal morbidity and mortality. Despite this seemingly low prevalence, pregnancy and the postpartum period confers a nearly 6–10‐fold increased risk of venous thromboembolism (VTE) in individuals of comparable childbearing age. Additionally, pulmonary embolism is a leading cause of maternal mortality in the United States, contributing to 9% of maternal deaths. Appreciation of the thrombotic risk of pregnancy demands knowledge of the sophisticated systems of coagulation and fibrinolysis and their inhibitors. Pregnancy‐specific risk factors that increase the risk for VTE include multiple gestation, preeclampsia, infection, postpartum hemorrhage, operative vaginal delivery, and cesarean delivery. Presentation of deep venous thrombosis and pulmonary embolism is similar to that in nonpregnant individuals but presenting symptoms can mimic common physical symptoms of pregnancy. Physicians should have a low index of suspicion to look for VTE when pregnancy individuals present with these symptoms.
 Computed Tomography deep venous thrombosis heparin lower extremity doppler low‐molecular weight heparin pulmonary embolism venous thromboembolism ventilation‐perfusion scan

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