[Risk factors and therapeutic strategies of deep venous thrombosis during pregnancy].

OBJECTIVE

To summarize the epidemiology and risk factors of deep venous thrombosis (DVT) during pregnancy and develop therapeutic strategies.

METHODS

Twenty-nine pregnant women with DVT were admitted into our hospital between 1991 and 2010. And their clinical data were retrospectively reviewed.

RESULTS

Among all cases, the occurrence (69%, 20/29) of DVT in the first trimester was highest as compared with those in the second and third trimesters. A previous history of DVT was a leading risk factor (24%, 7/29). Twenty-four cases (82.8%, 24/29) involved left lower extremities. Anticoagulation was the primary therapy. All cases were initially intravenously administrated with unfractioned heparin (UFH) or injected subcutaneously with low-molecule-weight heparin (LMWH). LMWH continued throughout pregnancy in 7 cases. The fetus had a normal development. Due to financial problems, 11 cases in the first trimester and 2 cases in the second trimester switched to oral warfarin from LMWH after the initial treatment. And warfarin was substituted by LMWH by Week 34. However the fetuses died in 4 cases while the other fetuses were normal. Nine cases in the first trimester decided to terminate pregnancy.

CONCLUSION

Treatment decisions during pregnancy carry potential implications for both maternal and fetal health and life. Therefore the DVT strategies during pregnancy differ from those during non-pregnancy. Special cautions should be exercised for the treatment of DVT during pregnancy.