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6 - Thromboprophylaxis and treatment of thrombosis in pregnancy

Published online by Cambridge University Press:  01 February 2010

By
L. Heilmann ,
W. Rath  and
R. L. Bick
Edited by
Rodger L. Bick ,
Eugene P. Frenkel ,
William F. Baker  and
Ravi Sarode
L. Heilmann
Affiliation:
Professor of Obstetrics and Gynaecology, City Hospital, Rüsselsheim
W. Rath
Affiliation:
Professor of Obstetrics and Gynaecology, University of Aachen, Aachen, Germany
R. L. Bick
Affiliation:
Clinical Professor of Medicine and Pathology, University of Texas Southwestern Medical Center; Director: Dallas
Rodger L. Bick
Affiliation:
University of Texas Southwestern Medical Center, Dallas
Eugene P. Frenkel
Affiliation:
University of Texas Southwestern Medical Center, Dallas
William F. Baker
Affiliation:
University of California, Los Angeles
Ravi Sarode
Affiliation:
University of Texas Southwestern Medical Center, Dallas
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Summary

Introduction

The true incidence of thromboembolic complications in pregnancy and the distribution of these events between the antenatal and postnatal periods are unknown. Early studies have estimated an incidence of symptomatic venous thrombosis during pregnancy using radiographic investigations between 0.5 and 3.0 per 1,000 deliveries. Lindqvist et al. used the Swedish national registries of births to investigate the number of objectively confirmed DVT between 1990 and 1993. The overall incidence of venous thromboembolic events was 1.3 per 1,000 deliveries in contrast to McColl et al. with 0.8 per 1,000 deliveries, Gherman et al. with 0.6 per 1,000 deliveries and Simpson et al. with 0.85 per 1,000 deliveries. More recent studies have demonstrated that antepartum deep vein thrombosis (DVT) is at least as common as postpartum DVT (Fig. 6.1) and can occur at any time during gestation, although pulmonary emboli (PE) remains more common postpartum. Earlier postpartum ambulation and discharge of patients from the hospital may have resulted in a relative decrease in postpartum events as compared to antepartum period, but the daily risk of thromboembolic complication was therefore highest in the postpartum period.

In a retrospective study McColl et al. described an incidence of DVT at 0.5 per 1,000 deliveries in the antenatal period and 0.21 in the puerperium. The incidence of pulmonary embolism was 0.07 per 1,000 deliveries and 0.08 in the puerperium respectively.

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Hematological Complications in Obstetrics, Pregnancy, and Gynecology , pp. 200 - 221
Publisher: Cambridge University Press
Print publication year: 2006

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References

A Working Group on behalf of the Obstetric Medicine Group of Australasia: Anticoagulation in pregnancy and the puerperium. MJA, 175: 258, 2001.
ACOG Practice Bulletin: Thromboembolism in pregnancy. No 19, 2000.
Armour, R., Schwedler, M., Kerstein, M. D.Current assessment of thromboembolic disease and pregnancy. Am. Surgeon 67: 641, 2001.Google Scholar
Backos, M., Chilcott, I., Rai, R.Pregnancy complications in women with recurrent miscarriage and antiphospholipid-antibodies treated with aspirin and heparin. Hum. Reprod. 12: 61, 1997.CrossRefGoogle Scholar
Bates, S. M., Ginsberg, J. S.How we manage venous thromboembolism during pregnancy. Blood, 100: 3470, 2002.CrossRefGoogle ScholarPubMed
Bates, S. M., Ginsberg, J. S.Pregnancy and deep vein thrombosis. Seminars Vasc. Med. 1: 97, 2001.CrossRefGoogle ScholarPubMed
Bergqvist D, Bergqvist A, Lindhagen A. Longterm outcome of patients with venous thromboembolism during pregnancy. In Greer, I. A., Turpie, A. G. C., Forbes, C. O., (eds.). Haemostasis and Thrombosis in Obstetrics and Gynecology. London; Chapman & Hall, 1992.Google Scholar
Bergqvist, D., Hedner, U.Pregnancy and venous thromboembolism. Acta Obstet. Gynecol. Scand. 62: 449, 1983.CrossRefGoogle Scholar
Bockarewa, M. I., Bremme, K., Blombäck, M.Arg 506-Gln mutation in factor V and risk of thrombosis during pregnancy. Br. J. Haematol. 92: 473, 1996.CrossRefGoogle Scholar
Branch, D. W., Silver, R. M., Blackwell, J. L.Outcome of treated pregnancies in women with antiphosopholipid syndrome. An update of the Utah experience. Obstet. Gynecol. 4: 614, 1992.Google Scholar
Brenner, B., Blumenfeld, Z.Thrombophilia and fetal loss. Blood Rev. 11: 72, 1997.CrossRefGoogle ScholarPubMed
Brenner, B., Kupferminc, M. J.Inherited thrombophilia and poor pregnancy outcome. Best Practice & Research Clinical Obstetrics & Gynaecology, 17: 427, 2003.CrossRefGoogle ScholarPubMed
Brenner, B.Antithrombotic prophylaxis for women with thrombophilia and pregnancy complications – Yes. J. Thromb. Haemost. 1: 2070, 2003.CrossRefGoogle ScholarPubMed
Brill-Edwards, P., Ginsberg, J. S., Gent, M., et al. Safety of withholding heparin in pregnant women with a history of venous thromboembolism. NEJM 343: 1439, 2000.CrossRefGoogle ScholarPubMed
Carr, M. H., Towers, C. V., Eastenson, A. R., et al. Prolonged bedrest during pregnancy: Does the risk of deep vein thrombosis warrant the use of routine heparin prophylaxis?J. Maternal Fetal Med. 6: 264, 1997.Google ScholarPubMed
Chan, W. S., Ray, J. G., Murray, S., et al. Suspected pulmonary embolism in pregnancy. Arch. Intern. Med. 162: 1170, 2002.CrossRefGoogle ScholarPubMed
Conard, J., Horellou, M. H., Dreden, P.Pregnancy and congenital deficiency in antithrombin III or protein C. Thromb. Haemost. 58: 39, 1987.Google Scholar
Conard, J., Horellou, M. H., Dreden, P.Thrombosis and pregnancy in congenital deficiencies in AT III, protein C or protein S. Thromb. Haemost. 63: 319, 1990.Google ScholarPubMed
Crowther, M. A., Kelton, J. G.Congenital thrombophilic states associated with venous thrombosis: A qualitative overview and proposed classification system. Ann. Intern. Med. 138: 128, 2003.CrossRefGoogle ScholarPubMed
Dahlback, B., Carlsson, M., Svensson, P. J.Familial thrombophilia due to a previously unrecognized mechanism characterized by poor anticoagulant response to activated protein C: prediction of a cofactor to activated protein C. PNAS 90: 1004, 1993.CrossRefGoogle ScholarPubMed
Stefano, V., Leone, G., Mastrangelo, S., et al. Thrombosis during pregnancy and surgery in patients with congenital deficiency of antithrombin III, protein C, protein S. Thromb. Haemost. 71: 799, 1994.Google ScholarPubMed
Stefano, V., Mastrangelo, S., Paciaroni, K.Thrombotic risk during pregnancy and puerperium in women with APC resistance-effective subcutaneous heparin prophylaxis in a pregnant patient. Thromb. Haemost. 74: 793, 1995.Google Scholar
Stefano, V., Rossi, E., Paciaroni, K., et al. Screening for inherited thrombophilia: indications and therapeutic implications. Haematologica, 87: 1095, 2002.Google ScholarPubMed
Swiet, M.Maternal mortality: Confidential enquiries into maternal deaths in the United Kingdom. Am. J. Obstet. Gynecol. 182: 760, 2000.CrossRefGoogle ScholarPubMed
Dilley, A., Austin, H., El-Jamil, M., et al. Genetic factors associated with thrombosis in pregnancy in a United States population. Am. J. Obstet. Gynecol. 183: 1271, 2000.CrossRefGoogle Scholar
Dizon-Townson, D. S., Nelson, L. M., Jang, H., et al. The incidence of the factor V Leiden mutation in an obstetric population and its relationship to deep vein thrombosis. Am. J. Obstet. Gynecol. 176: 883, 1997.CrossRefGoogle Scholar
Eldor, A.Thrombophilia, thrombosis and pregnancy. Thromb. Haemost. 86: 104, 2001.Google Scholar
Ensom, M. H. H., Stephenson, M. D.Low-molecular-weight heparins in pregnancy. Pharmacotherapy, 19: 1013, 1999.CrossRefGoogle ScholarPubMed
Fausett, M. B., Vogtlander, M., Lee, R. M., et al. Heparin-induced thrombocytopenia is rare in pregnancy. Am. J. Obstet. Gynecol. 185: 148, 2001.CrossRefGoogle ScholarPubMed
Friederich, P. W., Samson, B. J., Simioni, P.Frequency of pregnancy related thromboembolism in anticoagulant factor deficient women: Implications for prophylaxis. Ann. Intern. Med. 125: 955, 1996.CrossRefGoogle ScholarPubMed
Gates, S.Thromboembolic disease in pregnancy. Curr. Opin. Obstet. Gynecol. 12: 117, 2000.CrossRefGoogle ScholarPubMed
Gerhardt, A., Scharf, R. E., Beckmann, M. W., et al. Prothrombin and factor V mutations in women with a history of thrombosis during pregnancy and the puerperium. NEJM 342: 374, 2000.CrossRefGoogle ScholarPubMed
Gerhardt, A., Scharf, R. E., Zotz, R. B.Effect of hemostatic risk factors on the individual probability of thrombosis during pregnancy and the puerperium. Thromb. Haemost. 90: 77, 2003.CrossRefGoogle ScholarPubMed
Gherman, R. B., Goodwin, T. M., Leung, B., et al. Incidence, clinical characteristics, and timing of objectively diagnosed venous thromboembolism during pregnancy. Obstet. Gynecol. 94: 730, 1999.Google ScholarPubMed
Ginsberg, J. S., Bates, S. M.Management of venous thromboembolism during pregnancy. J. Thromb. Haemost. 1: 1435, 2003.CrossRefGoogle ScholarPubMed
Ginsberg, J. S., Greer, I. A., Hirsh, J.Use of antithrombotic agents during pregnancy. Chest, 119: 122, 2001.CrossRefGoogle ScholarPubMed
Ginsberg, J. S.Thromboembolism and pregnancy. Thromb. Haemost. 82: 620, 1999.Google Scholar
Girling, J., deSwiet, M.Inherited thrombophilia and pregnancy. Curr. Opin. Obstet. Gynecol. 10: 135, 1998.CrossRefGoogle Scholar
Grandone, E., Margaglione, M., Colaizzo, D., et al. Genetic susceptibility to pregnancy-related venous thromboembolism: Roles of factor V Leiden, prothrombin G20210 A, and methylenetetrahydrofolate reductase C677 T mutations. Am. J. Obstet. Gynecol. 179: 1324, 1998.CrossRefGoogle Scholar
Granger, K. A., Farquharson, R. G.Obstetric outcome in antiphospholipid syndrome. Lupus, 6: 509, 1997.CrossRefGoogle ScholarPubMed
Greer, I. A.Epidemiology, risk factors and prophylaxis of venous thromboembolism in obstetrics and gynecology. Baillieres Clin. Obstet. Gynecol. 11: 403, 1997.CrossRefGoogle Scholar
Greer, I. A.The special case of venous thromboembolism in pregnancy. Haemostasis, 28 (Suppl. 3): 22, 1998.Google ScholarPubMed
Greer, I. A., Swiet, M.Thrombosis prophylaxis in obstetrics and gynecology. BJOG 100: 37, 1993.CrossRefGoogle Scholar
Hallak, M., Senderowicz, J., Cassel, A.Activated protein C resistance (factor V Leiden) associated with thrombosis in pregnancy. Am. J. Obstet. Gynecol. 176: 889, 1997.CrossRefGoogle ScholarPubMed
Heilmann, L., Rath, W., v. Tempelhoff, G. F., et al. The use of low molecular weight heparin (LMWH) in pregnancy. Geburtsh Frauenheilk, 61: 355, 2001.CrossRefGoogle Scholar
Heilmann, L., Rath, W.Thrombophilia in Pregnancy. Bremen, London, New York; Unimed, 2002.Google Scholar
Hirsch, D. R., Mikkola, K. M., Marks, P. W.Pulmonary embolism and deep venous thrombosis during pregnancy or oral contraceptive use. Prevalence of factor V Leiden. Am. Heart J. 131: 1145, 1996.CrossRefGoogle ScholarPubMed
Katano, K., Aoki, K., Sasa, H.Beta-2-glycoprotein-1-dependent anticardiolipin antibodies as a predictor of adverse pregnancy outcomes in healthy pregnant women. Hum. Reprod. 11: 509, 1996.CrossRefGoogle ScholarPubMed
Khare, M., Nelson-Piercy, C.Acquired thrombophilias and pregnancy. Best Practice & Research Clinical Obstetrics & Gynaecology, 17: 491, 2003.CrossRefGoogle Scholar
Kovacevich, G. J., Gaich, S. A., Lavin, J. P., et al. The prevalence of thromboembolic events among women with extended bed rest prescribed as part of the treatment for premature labor or preterm premature rupture of membranes. Am. J. Obstet. Gynecol. 182: 1089, 2000.CrossRefGoogle ScholarPubMed
Krnic-Barrie, S., O'Connor, C. R., Looney, S. W.A retrospective review of 61 patients with antiphospholipid syndrome. Arch. Intern. Med. 157: 2101, 1997.CrossRefGoogle ScholarPubMed
Kupferminc, M. J., Eldor, A., Steinman, N.Increased frequency of genetic thrombophilia in women with complications of pregnancy. NEJM 340: 9, 1999.CrossRefGoogle ScholarPubMed
Kyrle, P. A., Minar, E., Hirschl, M., et al. High plasma levels of factor VIII and the risk of recurrent venous thromboembolism. NEJM 343: 457, 2000.CrossRefGoogle ScholarPubMed
Lepercq, J., Conard, J., Burel-Derlon, A., et al. Venous thromboembolism during pregnancy: a retrospective study of enoxaparin safety in 624 pregnancies. BJOG 108: 1134, 2001.Google ScholarPubMed
Lima, F., Khamashta, M. A., Buchanan, N. M. M.A study of sixty pregnancies in patients with the antiphospholipid syndrome. Clin. Exp. Rheumatol. 14: 131, 1996.Google ScholarPubMed
Lindhagen, A., Bergqvist, A., Bergqvist, D.Late venous function in the leg after deep venous thrombosis occurring in relation to pregnancy. BJOG 93: 348, 1986.Google Scholar
Lindqvist, P., Dahlback, B., Marsal, K.Thrombotic risk during pregnancy: A population study. Obstet. Gynecol. 94: 595, 1999.Google ScholarPubMed
Lindqvist, P. Risk estimation and prediction of preeclampsia, IUGR, and thrombosis in pregnancy (thesis). Malmö, Sweden, 1999.
Macklon, N. S., Greer, I. A.Venous thromboembolic disease in obstetrics and gynaecology. The Scottish experience. Scott. Med. J. 41: 83, 1996.CrossRefGoogle ScholarPubMed
McColl, M. D., Ellison, J., Reid, F., et al. Prothrombin 202210 G–A, MTHFR C677 T mutations in women with venous thromboembolism associated with pregnancy. BJOG 107: 565, 2000.CrossRefGoogle Scholar
McColl, M. D., Ramsay, J., Tait, R.Risk factors for pregnancy associated venous thromboembolism. Thromb. Haemost. 78: 1183, 1997.Google ScholarPubMed
McColl, M. D., Walker, I., Greer, I. A.The role of inherited thrombophilia in venous thromboembolism associated with pregnancy. BJOG 106: 756, 1999.CrossRefGoogle ScholarPubMed
Meroni, P. L., Moia, M., Derksen, R. H. W. M., et al. Venous thromboembolism in the antiphospholipid syndrome: management guidelines for secondary prophylaxis. Lupus, 12: 504, 2003.CrossRefGoogle ScholarPubMed
Murphy, R. P., Donoghue, C., Nallen, R. J., et al. Prospective evaluation of the risk conferred by factor V Leiden and thermolabile methylene-tetrahydrofolate reductase polymorphisms in pregnancy. Arterioscler. Thromb. Vasc. Biol. 20: 266, 2000.CrossRefGoogle ScholarPubMed
Nelson-Piercy, C.Prevention of thromboembolism in pregnancy. Scand. J. Rheumatol. 27 (Suppl. 107): 92, 1998.CrossRefGoogle Scholar
Nguyen, A.Prothrombin G20210 A polymorphism and thrombophilia. Mayo Clin. Proc. 75: 595, 2000.CrossRefGoogle Scholar
Pabinger, I., Grafenhofer, A., Kyrle, P. A., et al. Temporary increase in the risk for recurrence during pregnancy in women with a history of venous thromboembolism. Blood, 100: 1060, 2002.CrossRefGoogle ScholarPubMed
Pabinger, I., Schneider, B., For the Gesellschaft für Thrombose- und Hämostaseforschung (GTH) Study Group on Natural Inhibitor: Thrombotic risk in hereditary antithrombin III, protein C, or protein S deficiency. Arterioscler. Thromb. Vasc. Biol. 16: 742, 1996.CrossRefGoogle ScholarPubMed
Rai, R. S., Clifford, K., Cohen, H., et al. High prospective fetal loss rate in untreated pregnancies of women with recurrent miscarriage and antiphospholipid antibodies. Hum. Reprod. 10: 3301, 1995.CrossRefGoogle ScholarPubMed
Rand, H. J., Wu, X. X., Guller, S.Reduction of annexin V (placental anti-coagulant protein I) on placental villi of women with antiphospholipid antibodies and recurrent spontaneous abortion. Am. J. Obstet. Gynecol. 171: 1566, 1994.CrossRefGoogle Scholar
Raschke, R., Hirsh, J., Guidry, J. R.Suboptimal monitoring and dosing of unfractionated heparin in comparative studies with low molecular heparin. Ann. Intern. Med. 138: 720, 2003.CrossRefGoogle Scholar
Rath, W., Heilmann, L.Haemostatic Disorders in Obstetrics and Gynecology. New York, NY; Thieme Stuttgart, 1999.Google Scholar
Ray, J. G., Chan, W. S.Deep vein thrombosis during pregnancy and the puerperium: A metaanalysis of the period of risk and the leg of presentation. Obstet. Gynecol. Surv. 54: 265, 1999.CrossRefGoogle Scholar
Rosendaal, F. R.Risk factors for venous thrombotic disease. Thromb. Haemost. 82: 610, 1999.Google ScholarPubMed
Rutherford, S. W., Montero, M., McSchee, W.Thromboembolic disease associated with pregnancy: An 11 year review. Am. J. Obstet. Gynecol. 164: 286, 1991.Google Scholar
Sanson, B. J., Lensing, A. W. A., Prin, M. H.Safety of low molecular weight heparin in pregnancy: A systematic review. Thromb. Haemost. 81: 668, 1999.CrossRefGoogle ScholarPubMed
Silver, R. M., Draper, M. J., Scott, J. R.Clinical consequences of antiphospholipid antibodies: An historic cohort study. Obstet. Gynecol. 83: 372, 1994.Google ScholarPubMed
Simpson, E. L., Lawrenson, R. A., Nightingale, A. L., et al. Venous thromboembolism in pregnancy and the puerperium: incidence and additional risk factors from a London perinatal database. BJOG 108: 56, 2001.Google ScholarPubMed
Toglia, M. R., Weg, J. D.Venous thromboembolism during pregnancy. NEJM 335: 108, 1996.CrossRefGoogle ScholarPubMed
Tormene, D., Simioni, P., Prandoni, P., et al. Factor V Leiden mutation and the risk of venous thromboembolism in pregnant women. Haematologica, 86: 1305, 2001.Google ScholarPubMed
Walraven, C., Mamdani, M., Cohn, A., et al. Risk of subsequent thomboembolism for patients with pre-eclampsia. BMJ 326: 791, 2003.CrossRefGoogle Scholar
Vincente, V., Rodriguez, C., Soto, I.Risk of thrombosis during pregnancy and postpartum in hereditary thrombophilia. Am. J. Haematol. 46: 151, 1994.CrossRefGoogle Scholar
Wilson, W. A., Gharavi, A. E., Koike, T., et al. International consensus statement on preliminary classification criteria for definite anti-phospholipid syndrome. Arthritis & Rheumatism, 42: 1309, 1999.3.0.CO;2-F>CrossRefGoogle Scholar
Zotz, R. B., Gerhardt, A., Scharf, R. E.Prediction, prevention, and treatment of venous thromboembolic disease in pregnancy. Seminars in Thromb. and Haemost. 29: 143, 2003.CrossRefGoogle ScholarPubMed

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  • Thromboprophylaxis and treatment of thrombosis in pregnancy
    • By L. Heilmann, Professor of Obstetrics and Gynaecology, City Hospital, Rüsselsheim, W. Rath, Professor of Obstetrics and Gynaecology, University of Aachen, Aachen, Germany, R. L. Bick, Clinical Professor of Medicine and Pathology, University of Texas Southwestern Medical Center; Director: Dallas
  • Edited by Rodger L. Bick, University of Texas Southwestern Medical Center, Dallas, Eugene P. Frenkel, University of Texas Southwestern Medical Center, Dallas, William F. Baker, University of California, Los Angeles, Ravi Sarode, University of Texas Southwestern Medical Center, Dallas
  • Book: Hematological Complications in Obstetrics, Pregnancy, and Gynecology
  • Online publication: 01 February 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511526978.007
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  • Thromboprophylaxis and treatment of thrombosis in pregnancy
    • By L. Heilmann, Professor of Obstetrics and Gynaecology, City Hospital, Rüsselsheim, W. Rath, Professor of Obstetrics and Gynaecology, University of Aachen, Aachen, Germany, R. L. Bick, Clinical Professor of Medicine and Pathology, University of Texas Southwestern Medical Center; Director: Dallas
  • Edited by Rodger L. Bick, University of Texas Southwestern Medical Center, Dallas, Eugene P. Frenkel, University of Texas Southwestern Medical Center, Dallas, William F. Baker, University of California, Los Angeles, Ravi Sarode, University of Texas Southwestern Medical Center, Dallas
  • Book: Hematological Complications in Obstetrics, Pregnancy, and Gynecology
  • Online publication: 01 February 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511526978.007
Available formats
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  • Thromboprophylaxis and treatment of thrombosis in pregnancy
    • By L. Heilmann, Professor of Obstetrics and Gynaecology, City Hospital, Rüsselsheim, W. Rath, Professor of Obstetrics and Gynaecology, University of Aachen, Aachen, Germany, R. L. Bick, Clinical Professor of Medicine and Pathology, University of Texas Southwestern Medical Center; Director: Dallas
  • Edited by Rodger L. Bick, University of Texas Southwestern Medical Center, Dallas, Eugene P. Frenkel, University of Texas Southwestern Medical Center, Dallas, William F. Baker, University of California, Los Angeles, Ravi Sarode, University of Texas Southwestern Medical Center, Dallas
  • Book: Hematological Complications in Obstetrics, Pregnancy, and Gynecology
  • Online publication: 01 February 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511526978.007
Available formats
×