Key result
Venous thromboembolism in pregnancy is a leading cause of maternal mortality that is typically managed with low molecular weight heparin, though optimal diagnostic and treatment strategies require further research.
Why the study?
Venous thrombotic events are a leading cause of maternal mortality in developed countries, with challenges in diagnosis and uncertainty in prophylaxis strategies during pregnancy.
This review summarizes the diagnostic algorithms and treatment strategies, primarily low molecular weight heparin, for managing venous thromboembolism during pregnancy.
Suspected VTE evaluation in pregnancy should start with compression ultrasound; Level 5 evidence leaves open whether this improves diagnostic accuracy.
Venous thrombotic events (VTE) prevalence is estimated to be 1-2 for every 10,000 pregnancies, making it one of main causes of maternal mortality in developed countries. VTE’s leading risk factors are history of the condition and hereditary thrombophilia. D-dimer tests conducted during pregnancies have in many cases led to false positive results while a few false negatives have also been found. For pregnant women, it is important for evaluation to begin with compression ultrasound before magnetic resonance imaging, which seeks a negative test and focuses on the pelvis. On the other hand, a chest x-ray should be done for pulmonary embolism, which helps in deciding between a CT pulmonary angiogram and perfusion study for normal and abnormal x-ray, respectively. Generally, treatment is composed of heparin of low molecular weight for at least six weeks after childbirth. Thrombolysis can be significant for life-threatening and serious thrombolysis. For populations at high risk, VTE prophylaxis still faces a lot of uncertainty. In fact, there is still little evidence to support the essence of mechanical prophylaxis for all women who have delivered through cesarean.
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Fasoulakis et al. (2021) conducted a review in Deep vein thrombosis in pregnancy. Venous thromboembolism in pregnancy is a leading cause of maternal mortality that is typically managed with low molecular weight heparin, though optimal diagnostic and treatment strategies require further research.
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