DVT (Deep Vein Thrombosis) During Pregnancy

Deep vein thrombosis (DVT) during pregnancy definitions and facts

Pregnant women with DVT
During pregnancy, factors that increase the risk of developing DVT include varicose veins, diabetes multiple gestations, and more.

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

SLIDESHOW

A Visual Guide to Deep Vein Thrombosis (DVT) See Slideshow

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:

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 (Coumadin, Jantoven) 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.
References
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. 
<https://www.uptodate.com/contents/deep-vein-thrombosis-dvt-beyond-the-basics?search=DVT&source=search_result&selectedTitle=3~150&usage_type=default&display_rank=3#H248133985>