Skip to main content

Deep Vein Thrombosis and Pulmonary Embolus in Pregnancy

Sarah Tiggelaar, MD, CLC, FAAFP and Lamia F. AbiSamra, MD Reviewed 05/2023
 


BASICS

DESCRIPTION

Both pregnancy and the puerperium are risk factors for deep vein thrombosis (DVT) and pulmonary embolism (PE); collectively referred to as venous thromboembolic disease. Pregnancy-re...

DIAGNOSIS

HISTORY

  • Often asymptomatic, but 80% present with a swollen painful lower extremity (3)

  • DVT: leg pain, swelling (most common in left leg [70–90%])

  • PE: dyspnea, pleuritic pain, cough, syncope

PHYSICAL EXAM

TREATMENT

GENERAL MEASURES

  • Anticoagulation indicated for confirmed acute VTE (DVT, PE) for minimum 3-6 months and at least 6 weeks postpartum.

  • LMWH and unfractionated heparin (UFH) do not cross the plac...

ONGOING CARE

Risk of osteoporosis secondary to Heparinoids is recognized and can be addressed by oral calcium supplements. 

FOLLOW-UP RECOMMENDATIONS

  • Postpartum anticoagulation for acute VTE:

    • LMWH or UFH...

REFERENCES

1
Hoyert DL. Maternal mortality rates in the United States, 2020. National Center for Health Statistics Health E-Stats, 2022.
2
Creanga AA, Syverson C, Seed K, et al. Pregnancy-related mortali...

ADDITIONAL READING

  • Bates  SM, Greer  IA, Middeldorp  S, et al. VTE, thrombophilia, antithrombotic therapy, and pregnancy: Antithrombotic Therapy and Prevention of Thrombosis...

CODES

ICD10

  • O22.30 Deep phlebothrombosis in pregnancy, unspecified trimester

  • O88.219 Thromboembolism in pregnancy, unspecified trimester

SNOMED

  • 682004 Thrombosis complicating pregnancy AND/OR puerperium (...

CLINICAL PEARLS

  • Pregnancy and the puerperium are risk factors for VTE, with the highest risk in the postpartum period.

  • Add color-flow Doppler US to the traditionally used CCUS in pregnant patients to b...

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.

×