Blood Clot Problems in Pregnancy and Soon Thereafter Are Infrequent but Can be Life-threatening

Main Category: Pregnancy / Obstetrics
Also Included In: Vascular
Article Date: 17 Nov 2005 - 2:00 PDT

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Pregnant women and women in the three months following delivery had four times more blood clot problems, including deep vein thrombosis and pulmonary embolism (together often called venous thromboembolism) than nonpregnant women in the same age range, a new study finds (Article, p. 697). These rates are higher than previously published estimates.

Researchers looked at records of 50,000 women who were pregnant between 1966 and 1995. One hundred developed deep vein thrombosis, pulmonary embolism, or both. The incidence of venous thromboembolism increased with each trimester of pregnancy and was highest in the postpartum period. In the postpartum period, the incidence of pulmonary embolism, in which a blood clot breaks loose and lodges in the lungs, was 15 times higher than during the pregnancy itself. Older mothers in the first weeks after delivery had the highest risk for pulmonary embolism.

An editorial writer says that, however rare, during the last 20 to 30 years pulmonary embolism has become the leading cause of maternal death in the United States (Editorial, p. 749).

Although the study highlights the importance of the postpartum period in development of venous thromboembolism, the writer says, physicians need stronger evidence and more specific risk profiles before prescribing anticoagulant therapy for pregnant and postpartum women.

Susan Anderson
sanderson@acponline.org
American College of Physicians
http://www.acponline.org
Annals of Internal Medicine tip sheet for Nov. 15, 2005, issue

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