DVT (Deep Vein Thrombosis) During Pregnancy Symptoms, Causes, Risk Factors, and Treatment Guidelines

  • Medical Author:
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Deep vein thrombosis (DVT) during pregnancy definitions and facts

  • The most common type of venous thromboembolism (VTE) is deep vein thrombosis (DVT), which refers to blood clots in the deep veins of the leg, arm, or pelvis.
  • When blood clots form in the deep veins of the legs, thighs, or pelvis, the signs and symptoms include swelling, pain, warmth, and redness in the affected leg.
  • Pregnancy is a risk factor for the development of deep vein thrombosis.
  • During pregnancy, factors that increase risk of developing DVT include:
  • The risk for DVT increases in the postpartum period. Factors that increase the risk of developing DVT in the postpartum period include:
  • Anticoagulation therapy including use of low-molecular-weight heparins (LMWHs) is the treatment for DVT diagnosed during pregnancy.
  • If a blood clot in the legs breaks off and travels to the lungs, this can result in a pulmonary embolism (PE), which can be fatal.

DVT and Birth Control Pills (Oral Contraceptives) Risks and Options

Deep vein thrombosis or DVT is a blood clot that has traveled to the veins deep within the legs, thighs, pelvis, and arms. Taking birth control pills can increase the risk for developing blood clots or DVT, slightly. These risks are highest during the first year of taking the pills, and then decreases slightly from then on. However, this increased risk still is less than the risks of developing DVT during pregnancy or postpartum.

DVT can be fatal if it travels to the lungs and causes a blood clot in the lung (pulmonary embolism).

What is DVT (deep vein thrombosis)?

A venous thromboembolism (VTE) is a blood clot in a deep vein. The most common type of VTE is deep vein thrombosis (DVT), which refers to blood clots in the deep veins of the leg, arm, or pelvis. When blood clots form in the deep veins of the legs, thighs, or pelvis, this can cause blood to back up, resulting in swelling and pain.

DVT can be dangerous because if the blood clot breaks off, it can travel to other parts of the body and block blood vessels there. Blood clots can travel from the legs to the lungs causing pulmonary embolism (PE), which can be fatal.

What are the signs and symptoms of DVT?

Common symptoms of DVT in the legs include:

  • Swelling
  • Pain
  • Warmth
  • Redness

What are the risk factors for developing DVT during pregnancy?

Pregnancy itself is a risk factor developing of deep vein thrombosis (DVT). Pregnant women have venous thromboembolism (VTE) at a rate 4 to 50 times higher than women who are not pregnant. The risk for venous thromboembolism is higher in the postpartum period, right after a woman has given birth, is two to five times greater.

During pregnancy, factors that increase the risk of DVT and venous thromboembolism include:

What are the risk factors for developing DVT postpartum?

In the postpartum period, particularly within the first 6 weeks after delivery, risk factors for VTE/DVT include:

  • Cesarean section, particularly emergency C-sections
  • Stillbirth
  • High blood pressure (hypertension)
  • Eclampsia or preeclampsia
  • Postpartum infection
  • Obstetric hemorrhage
  • Preterm delivery at less than 36 weeks
  • Other underlying medical conditions (such as cardiac disease, varicose veins, inflammatory bowel disease)
  • A body mass index (BMI) of 25 or greater
  • Age over 35 years
  • Smoking

Quick GuideDVT in Pictures: Symptoms of Deep Vein Thrombosis, Beyond Leg Pain and More

DVT in Pictures: Symptoms of Deep Vein Thrombosis, Beyond Leg Pain and More

What are the treatment and management guidelines for DVT during pregnancy?

Anticoagulation therapy is the treatment for DVT diagnosed during pregnancy. Low-molecular-weight heparins (LMWHs) usually are the first-line medications. Anticoagulant therapy may need to be continued into the postpartum period when the risk of DVT/VTE increases.

Warfarin should be avoided during pregnancy because it can harm a developing fetus.

Is DVT dangerous during pregnancy? Can it be fatal?

If a blood clot in the legs breaks off and travels to the lungs, this can result in a pulmonary embolism (PE), which can be fatal. PE is the seventh leading cause of maternal death (mortality), accounting for 9% of maternal deaths.

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Medically Reviewed on 9/18/2018
References
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Malhotra, MD, Atul and Steven E Weinberger, MD. Deep vein thrombosis and pulmonary embolism in pregnancy: Treatment. 27 November 2017.
<https://www.uptodate.com/contents/deep-vein-thrombosis-and-pulmonary-embolism-in-pregnancy-treatment>

Malhotra, MD, Atul and Steven E Weinberger, MD. Deep vein thrombosis in pregnancy: Epidemiology, pathogenesis, and diagnosis. 7 January 2017. 
<https://www.uptodate.com/contents/deep-vein-thrombosis-in-pregnancy-epidemiology-pathogenesis-and-diagnosis?search=DVT%20pregnancy&source=search_result&selectedTitle=3~150&usage_type=default&display_rank=3>

Pai, MD, FRCPC, Menaka and James D Douketis, MD, FRCPC, FACP, FCCP. Patient education: Deep vein thrombosis (DVT) (Beyond the Basics). Updated: May 02, 2018. 
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