Pregnant, Postpartum Women at Increased Risk of Fatal Blood Clots, Study Says

Main Category: Vascular
Also Included In: Pregnancy / Obstetrics;  Women's Health / Gynecology
Article Date: 17 Nov 2005 - 0:00 PDT

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Pregnant women and women who have given birth within the past three months are four times as likely to experience "serious blood clot problems" as women in similar age groups who are not or have not recently been pregnant, according to a study published in the Nov. 15 issue of the Annals of Internal Medicine, the AP/Miami Herald reports. John Heit from the Mayo Clinic and colleagues examined the medical records of 50,000 pregnant women who lived in Olmsted County, Minn. The records were collected between 1966 and 1995 as part of a broader health evaulation project. The study found 105 cases of deep vein thrombosis, or blood clots in leg veins, and pulmonary embolism, or blood clots in the lungs, during pregnancy or the postpartum period. Although these types of blood clots are rare, Heit said the evidence is cause for concern because they often are fatal. Researchers said the study included primarily white women, so the findings might not apply to women of other races. Gary Hankins, an American College of Obstetricians and Gynecologists committee chair and OB/GYN, said that ACOG is writing new guidelines on preventing blood clots during pregnancy and the postpartum period. Doctors need to advise pregnant women and women who have recently given birth to remain active, according to the Herald. For women with an increased risk of blood clots -- because of obesity, a history of clots or extended bed rest during pregnancy -- doctors might consider using leg compression devices in the hospital to stimulate blood circulation, the Herald writes. Anticoagulants are not recommended because they can cause other complications, such as excessive bleeding, according to the Herald (Loviglio, AP/Miami Herald, 11/14).

Editorial
In an accompanying editorial, Richard Lee of the State University of New York-Buffalo writes that previous studies on pulmonary embolisms and DVT have had "serious shortcomings" that this study "manage[s] to address," such as specifying the patient's age and if she had a history of blood clots. Heit's study provided "solid clinical evidence to confirm current clinical wisdom" that pregnancy increases the risk of blood clots, which have become the number one cause of maternal death over the past 20 to 30 years, Lee writes. "Although Heit and his colleagues have provided a good model for rigorous population-based study of pregnancy-related [blood clots], their study did not address the many key questions about clinical management," Lee writes, concluding, "Clinicians need large, high-quality studies that do address the management of [blood clot] risks in pregnant and postpartum women" (Lee, Annals of Internal Medicine, 11/15).

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