The acute management of venous thromboembolism in pregnancy

Venous thromboembolism, which involves venous thrombosis and pulmonary embolism, is a leading cause of morbidity and mortality in hospitalized patients and is being seen with increasing frequency in outpatients. This chapter discusses the risk factors, etiology, classification, pathophysiology, natural history, prognosis, diagnosis (including venous thrombosis, recurrent venous thrombosis, and pulmonary embolism), prophylaxis, and treatment of venous thromboembolism (including the pharmacology of antithrombotic agents), as well as venous thromboembolism in pregnancy and miscellaneous thromboembolic disorders (including thrombosis of unusual sites). This review contains 8 figures, 16 tables, and 79 references. Keywords: Venous thromboembolism, pulmonary embolism, deep vein thrombosis, embolectomy, thrombolysis, hypercoagulability, duplex ultrasonography, D-dimer, anticoagulation

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Obstetrics

Oxford Handbook of Clinical Specialties ◽

10.1093/med/9780198827191.003.0001 ◽

2020 ◽

pp. 1-103

Author(s):

Charlotte Goumalatsou

Keyword(s):

Diabetes Mellitus ◽

Human Immunodeficiency Virus ◽

Venous Thromboembolism ◽

Connective Tissue ◽

Cardiac Disease ◽

Postnatal Care ◽

Hyperemesis Gravidarum ◽

Immunodeficiency Virus ◽

Obstetric Emergencies ◽

In Pregnancy

This chapter in the Oxford Handbook of Clinical Specialties describes the obstetrics specialty, including antenatal care and screening. Medical conditions in pregnancy are investigated, including hyperemesis gravidarum, sickle-cell disease, cardiac disease, psychiatry, epilepsy, anaemia, HIV (human immunodeficiency virus), diabetes mellitus, thyroid disease, jaundice, malaria, renal disease, respiratory disease, connective tissue disease, hypertension, thromboprophylaxis, thrombophilia, and venous thromboembolism. Antenatal problems are explored, leading on to a discussion of labour and delivery, postnatal care, and obstetric emergencies.

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Thrombotic complications in pregnant patients with rheumatic disease

Practical management of the pregnant patient with rheumatic disease ◽

10.1093/med/9780198845096.003.0002 ◽

2021 ◽

pp. 21-32

Author(s):

Andrew James Doyle ◽

Beverley Jane Hunt

Keyword(s):

Venous Thromboembolism ◽

Rheumatic Disease ◽

Antiphospholipid Antibodies ◽

Obstetric Complications ◽

Pregnancy And Postpartum ◽

Thrombotic Complications ◽

In Pregnancy

Rheumatic disease and pregnancy are both associated with increased rates of venous thromboembolism. In pregnancy, the highest risk is in the later stages of pregnancy and postpartum. The management of anticoagulation to provide thromboprophylaxis, for treatment of acute thromboembolism or for prevention of secondary recurrence can cause issues throughout pregnancy for the clinician and patient, particularly around the time of delivery. In those with rheumatic disease, this can be complicated by the presence of antiphospholipid antibodies, which are associated with venous, arterial, and microvascular thromboembolism and obstetric complications. We discuss the management of thrombotic conditions during pregnancy and the post-natal period and considerations that the clinicians should be aware of.

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