Thromboembolism in pregnancy: recurrence risks, prevention and management.
PURPOSE OF REVIEW: The purpose of this review is to summarize the epidemiology of thromboembolism in pregnancy and describe strategies to prevent and treat it. RECENT FINDINGS: The main reason for the increased risk of thrombosis in pregnancy is hypercoagulability. Other risk factors include a history of thrombosis, inherited and acquired thrombophilia, certain medical conditions, and complications of pregnancy and childbirth. SUMMARY: The hypercoagulability of pregnancy is present as early as the first trimester and so is the increased risk of thrombosis. Candidates for anticoagulation are women with a current thrombosis, a history of thrombosis, thrombophilia and a history of poor pregnancy outcome, or risk factors for postpartum thrombosis. For fetal reasons, the preferred agents for anticoagulation in pregnancy are heparins. There are no large trials of anticoagulants in pregnancy and recommendations are based on case series and the opinion of experts. Nonetheless, anticoagulants are believed to improve the outcome of pregnancy for women and their fetuses.
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