Venous thromboembolism in pregnancy

The risk of venous thromboembolism is increased during pregnancy. Although the absolute overall risk of deep venous thrombosis (DVT) or pulmonary embolism (PE) in pregnancy is low, clinicians are highly vigilant to the development of this disease in pregnancy because of the severe consequences to both mother and child if this condition is not diagnosed, treated and prevented. Although prompt recognition and diagnosis of DVT or PE is critical to reduce maternal morbidity, diagnosis of both DVT and PE currently relies on data from studies in nonpregnant patients. However, there are some recent studies offering new insights in this area. The development of venous thromboembolism during pregnancy is influenced by inherent patient risk factors, pregnancy-associated risk factors, and the mode and type of delivery. The degree of risk increase from these factors individually and in combination, to warrant routine thromboprophylaxis, weighed against bleeding risks, is not yet defined. With increased use of assisted reproductive techniques to achieve pregnancy, clinicians must also be vigilant to the development of venous thrombosis in early pregnancy, occurring in unusual sites such as the upper extremities.