Anticoagulant treatment during pregnancy: an update.

During pregnancy and the immediate puerperium, the risk for venous thromboembolism (VTE) is substantially increased. Certain medical conditions, including inherited or acquired thrombophilias, and obstetric manipulations such as cesarean delivery further increase this risk. Consequently, acute VTE is one of the leading causes of maternal morbidity and direct mortality in the United States and other developed countries. That considered, clinicians and researchers must understand how to effectively use anticoagulant drugs during pregnancy, and must recognize areas for improvement in the knowledge of these medications. These areas are especially important, because the use of anticoagulants during pregnancy may even increase in light of recent information indicating that thrombophilia is associated with certain more common obstetrical complications.