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Venous Thromboembolism and Pregnancy: What Are the Risks?

Overview

Diagnosis

Being pregnant is a special time for any woman, but there are certain medical conditions that can be very dangerous during pregnancy. Venous thromboembolism is a very serious disease that can pose multiple threats to you especially when pregnant.

Learn more about this serious condition and what you can do to protect yourself and your pregnancy.

What Is Venous Thromboembolism?

Venous thromboembolism (VTE) refers to the formation of blood clots in a vein. A blood clot that forms in a deep vein, such as the leg area, is called deep vein thrombosis or DVT. If the clot goes to the lungs, it is called a pulmonary embolism (PE). The combination of a DVT and a PE are referred to as VTE. Each condition is extremely dangerous and VTE can lead to death, especially if untreated.

It is believed that there are about 10 million cases of VTE worldwide. Many cases go undocumented. This is especially the case in low-income countries. The actual numbers could be much higher. In fact, in the United States and the United Kingdom, VTE is responsible for more deaths than AIDS, breast cancer, prostate cancer, and car accidents combined.

VTE and Pregnancy

VTE can affect both hospitalized and non-hospitalized people. It can reoccur and often goes overlooked. This can result in long-term health complications.

The physical and anatomical changes that your body goes through when you are pregnant can make it difficult to diagnosis VTE. According to the American Academy of Family Physician Journal VTE is the leading cause of maternal death in the United States.

Body Changes During Pregnancy

Some of the testing for VTE poses radiation and other risks that could be harmful to an unborn fetus. Doctors have to use caution when treating a pregnant woman.

During a normal pregnancy, your body automatically increases its clotting factors. This is described as a hypercoagulable state. It’s theorized that your body enters this state to help protect you from hemorrhaging when you deliver or if you were to suffer a miscarriage. According to the American Journal of Medicine, women are four times more likely to suffer from VTE during pregnancy compared to when they are not pregnant.

Risk Factors for VTE During Pregnancy

Risk Factors

Hormonal changes during pregnancy increase your risk of VTE. The risk of VTE is also higher following a cesarean delivery than it is following a vaginal delivery.

There are several risk factors that can increase your chance of developing VTE during pregnancy. Increased venous stasis, or the loss of proper function of the veins in your legs, is one of the biggest risk factors for VTE during pregnancy.

Complications during your pregnancy and your delivery can also elevate your risk of VTE during pregnancy. Complications include:

  • multiple births
  • preeclampsia
  • postpartum bleeding
  • blood transfusions
  • prolonged bed rest
  • swelling of your legs, ankles, or feet
  • cesarean delivery
  • prolonged labor

If you have a history of VTE, DVT, PE, or acquired thrombophilia you have a greater risk of developing VTE. Your risk of VTE also increases if you:

  • are 35 years of age or older
  • smoke
  • have a history of heart disease
  • suffer from obesity
  • have a hematological disorder
  • have a family history of VTE
  • are obese

Additionally, long distance travel, or travel that takes over four hours, may also increase your risk of VTE.

How Is VTE Diagnosed?

It can be difficult to diagnose VTE during pregnancy. The following symptoms can be a sign of VTE, or they may be a result of the normal changes your body goes through during pregnancy:

  • tachycardia, or abnormally rapid heart rate
  • leg swelling
  • tachypnea, or abnormally rapid breathing
  • dyspnea, difficult or labored breathing

If you have these symptoms, your doctor may do further testing to identify whether you have VTE. Testing may include:

  • a compression ultrasonography
  • a magnetic resonance imaging test (MRI)
  • a venogram

Compression ultrasonography is noninvasive, safe, and relatively inexpensive. It is the go-to choice when testing for DVT. Ventilation perfusion scanning, or V/Q scan, is generally the most reliable test for diagnosing PE.

Even though there are many cases of VTE a year, many people are not aware of the disease. It often falls below the radar. You may not even realize that VTE is preventable.

Up to 60 percent of people who develop VTE develop it during or shortly after a hospital stay. DVT is a leading preventable cause of hospital death. Depending on your medical history your doctor may deem you “at risk” and carefully monitor you for DVT, PE, or VTE during your pregnancy.

VTE Treatment During Pregnancy

Treatment

There are still a lot of research and clinical trials being conducted concerning VTE. If you are diagnosed with DVT or PE while you are pregnant, your doctor will immediately begin treatment. Anticoagulation drugs, or blood thinners, are generally used if you are diagnosed with VTE. Heparin is often used to help manage your VTE while you are pregnant.

Treating Venous Thromboembolism: Know Your Treatment Options

If you become pregnant and have ever suffered from DVT, PE, VTE, or if you have any of the risk factors, you should talk to your doctor. They can conduct a VTE assessment and determine your potential risk.

VTE not only poses a danger to your unborn fetus, it also poses a risk to your life. Let your doctor know about any problems or warning symptoms that you experience. Prevention and early detection are the keys to fighting VTE.

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