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10 - Thromboembolic disorders of pregnancy
- By Mark Tindall, Consultant in Anaesthesia, Dudley Group of Hospitals, Dudley, West Midlands, UK
Alexander Heazell, University of Manchester, John Clift
Book:

Obstetrics for Anaesthetists

Published online:

21 August 2009

Print publication:

06 March 2008, pp 120-129
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Summary

Successive reports from the Confidential Enquiry into Maternal and Child Health (CEMACH) have highlighted failures in recognition of risk factors for venous thromboembolism (VTE) and provision of adequate prophylaxis. VTE is a significant cause of mortality and morbidity in pregnancy. There are two different manifestations of VTE - deep vein thrombosis (DVT) and pulmonary embolism (PE). DVT organizes clots that occur in the venous system, usually in the large veins of the leg or pelvis. PE is a clot that causes occlusion of artery in the pulmonary circulation. The blockage of the artery can be caused by air, fat, amniotic fluid or blood clot. The accurate diagnosis of VTE requires both clinical assessment and objective testing. Spiral CT scan is used to identify PE. Both the prophylaxis and treatment of VTE can potentially have implications on the provision of regional anaesthesia or analgesia during labour and delivery.