Deep venous thrombosis in obstetrics practice
Deka, D.
Journal of the Indian Medical Association 108(4): 233-234; 238-240, 242
2010
ISSN/ISBN: 0019-5847 PMID: 21114191 Document Number: 11924
Venous thrombosis, including deep vein thrombosis (DVT) and pulmonary embolism (PE), occurs at an annual incidence of about 1 per 1,000 adults'. Rates increase sharply after about age 45 years, and are slightly higher in men than women in older age. Major risk factors for thrombosis, other than age, include exogenous factors such as surgery, hospitalisation, immobility, trauma, pregnancy, and the puerperium and hormone use, and endogenous factors such as cancer, obesity, and inherited and acquired disorders of hypercoagulation. In conclusion, clinical signs and symptoms of thrombosis are very unreliable in pregnant women but more reliable in puerperal women. Objective diagnosis of thrombosis is important in pregnant women. Special approaches are used to diagnose suspected DVT in pregnancy, the optimal strategy is to use ultrasound selectively in patients with a high clinical risk or positive D-dimer. It is recommended that patients with DVT during pregnancy should be treated with conventional full-dose intravenous heparin therapy for 5 to 10 days, followed by subcutaneous low-dose heparin until labour, and continued for 6 weeks postpartum.
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