Thrombosis during pregnancy and the postpartum period.

OBJECTIVE: To describe the circumstances surrounding deep vein thrombosis among pregnant or postpartum patients enrolled in a large multicenter registry. STUDY DESIGN: Consecutive patients with ultrasound-confirmed deep vein thrombosis were enrolled at 183 institutions during a 6-month period from October 2001 to March 2002. Fifty-three who were either pregnant or within 6 weeks postpartum were analyzed. RESULTS: Thirty-four were pregnant and 19 were postpartum. Among those pregnant, 44% experienced deep vein thrombosis in the first trimester, 24% in the second, and 26% in the third. Deep vein thrombosis occurred in the left lower extremity in 76% of the pregnant and 47% of the postpartum women. Four pregnant and 2 postpartum women had pelvic vein thrombosis. Among those postpartum, 74% had undergone surgery within 3 months. CONCLUSION: During pregnancy, the risk of deep vein thrombosis begins in the first trimester. Thus, we believe that when prophylaxis is indicated, it should be initiated early in gestation.

Duke Scholars

Author Andra Hohler James Obstetrics and Gynecology, Maternal Fetal Medicine