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Thromboembolic disorders in pregnancy 

Thromboembolic disorders in pregnancy
Chapter:
Thromboembolic disorders in pregnancy
Author(s):

Salma Ballal

and Ian A. Greer

DOI:
10.1093/med/9780198713333.003.0037
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date: 27 February 2020

Thromboembolism in pregnancy remains a major cause of direct maternal mortality in the Western world. Thromboembolic events in pregnancy are spread across the three trimesters but the puerperium is the time of greatest risk with a relative risk of around 20-fold compared to the non-pregnant patient. When compared to the non-pregnant population where distal deep vein thrombosis is most common, most events in pregnancy are iliofemoral and left sided. Given the multi-hit nature of the problem, awareness of risk factors is important. The two most significant single risk factors in pregnancy for thromboembolism are history of previous venous thromboembolism and thrombophilia. The identification of risk factors will guide the use of thromboprophylaxis and assist diagnosis; however, objective diagnosis is required. Prophylaxis and treatment focuses on low-molecular-weight heparin, which is considered safe in pregnancy.

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