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Management of deep vein thrombosis during pregnancy
Thursday, December 6, 2012
Low molecular weight heparin are the anticoagulants of choice for the treatment of an acute venous thromboembolism in pregnancy and they are also favored by many clinicians in the period following delivery.
Treatment with warfarin is uncommon in pregnancy and its use in the first trimester results in the 'warfarin syndrome'. Its use in the second trimester results in micro hemorrhages in the brain of the fetus and during the third trimester can cause major intracranial bleeding and placental abruption.
Adjusted odds ratio of developing venous thromboembolism during pregnancy if you have this underlying problem:
previous venous thromboembolism - increases your risk 25.8 times
age over 35 - increases your risk 1.3 times
body mass index above 30 - increases your risk 5.3 times
immobility - increases your risk 7.7 times
smoking - increases the risk 2.7 times
varicose veins - increases the risk 2.4 times

Elevated circulating levels of Factor VII, Factor VIII, Factor X and Factor XII during pegnancy increase risk of developing venous thromboembolism. This risk is highest right after delivery of the baby (the puerperium).


There are also a reduction in sensitivity to activated protein C and functional protein S levels during pregnancy.


The risk of develoing venous thromboembolism during pregnancy is 0.66 per 100.


This data is from P Kesteven and colleagues and the article is published in Phlebology 2012; volume 27 Supplement: pages 73-80.


Dr. Hratch Karamanoukian is a member of the American College of Phlebology AND a Diplomate of the American Board of Phlebology. He can be contacted by calling 716-839-3638 or 


Dr. Raffy Karamanoukian is a member of the American College of Phlebology AND a Diplomate of the American Board of Phlebology. He can be contacted by calling 310-998-5535 or 


Drs. Raffy and Hratch Karamanoukian have authored 6 books about venous disease. The books are available on Amazon Kindle and Nook books for download.


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