General Obstetrics and Gynecology: ObstetricsThrombosis during pregnancy and the postpartum period
Section snippets
Material and methods
Institutional review board approval was obtained from each participating institution.
Consecutive patients with acute DVT confirmed by venous duplex ultrasound and who agreed to participate were enrolled. There were no exclusions. Data were obtained from medical records and recorded on case report forms by a study coordinator. Coexisting medical conditions or comorbidities were specified according to a prespecified list. Obesity was defined as a body mass index (BMI) greater than 30 kg/m2.
Results
Of the 5451 patients, 2559 were men and 2892 were women. Of the 2892 women, 53 (2%) were either pregnant or postpartum. Of these 53, 34 (64%) were pregnant and 19 (36%) were postpartum. Of the 45 women for whom information on age was available, the median age was 29 years. The racial distribution of the pregnant and postpartum patients was 27 (51%) Caucasian, 12 (23%) African American, 8 (15%) Hispanic, 3 (6%) other, and 3 (6%) unknown. Of the 41 women for whom BMI was recorded, 15 (37%) were
Comment
We found that approximately two-thirds of DVT occurred antepartum and one-third occurred postpartum, consistent with the findings of a meta-analysis.10 In this meta-analysis, 22% of antepartum DVT occurred during the first trimester, 34% in the second, and 48% in the third.10 In our study, no additional testing was performed to confirm the diagnosis of pregnancy, so it is possible that patients with undiagnosed or very early pregnancy may have been excluded. Nonetheless, we found that almost
References (16)
- et al.
How strong is the association between maternal thrombophilia and adverse pregnancy outcome? A systematic review
Eur J Obstet Gynecol Reprod Biol
(2002) Inherited thrombophilias in pregnant patients: detection and treatment paradigm
Obstet Gynecol
(2002)- et al.
A prospective registry of 5,451 patients with ultrasound-confirmed deep vein thrombosis
Am J Cardiol
(2004) - et al.
Use of antithrombotic agents during pregnancy
Chest
(2001) Venous thromboembolism in the pregnant woman
J Reprod Med
(2003)Prevention of venous thrombosis and pulmonary embolism. NIH Consensus Development
JAMA
(1986)- World Health Organization. Maternal mortality in 2000: estimates developed by WHO, UNICEF and UNFPA. WHO; Geneva;...
- et al.
Pregnancy-related mortality surveillance–United States, 1991–1999
MMWR Surveill Summ
(2003)
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Supported by an educational grant from Aventis Pharmaceuticals Inc.