Deep vein thrombosis and pulmonary embolism in pregnancy: Treatment
- David R Schwartz, MD
David R Schwartz, MD
- Associate Professor of Clinical Medicine
- Section Chief, Critical Care
- NYU Medical Center
- Atul Malhotra, MD
Atul Malhotra, MD
- Kenneth M Moser Professor, Department of Medicine
- University of California, San Diego
- Steven E Weinberger, MD
Steven E Weinberger, MD
- Adjunct Professor of Medicine
- University of Pennsylvania School of Medicine
- Executive Vice President and CEO
- American College of Physicians
- Section Editors
- Lawrence LK Leung, MD
Lawrence LK Leung, MD
- Editor-in-Chief — Hematology
- Section Editor — Disorders of Hemostasis and Coagulation
- Professor of Medicine
- Stanford University School of Medicine
- Charles J Lockwood, MD, MHCM
Charles J Lockwood, MD, MHCM
- Section Editor — Obstetrics
- Senior Vice President, USF Health
- Dean, Morsani College of Medicine
- Professor, Obstetrics and Gynecology
- University of South Florida
- Jess Mandel, MD
Jess Mandel, MD
- Section Editor — Pulmonary Vascular Disease
- Professor of Medicine
- University of California, San Diego
Pregnancy and the puerperium are well-established risk factors for deep vein thrombosis (DVT) and pulmonary embolism (PE), which are collectively referred to as venous thromboembolic disease (VTE). Treatment of VTE in pregnant patients is unique in several ways. (See "Use of anticoagulants during pregnancy and postpartum".)
●Warfarin is generally not used, particularly in the first trimester, because it may be teratogenic.
●Synthetic heparin pentasaccharides (eg, fondaparinux, idraparinux) are avoided due to a paucity of safety data for these agents.
●Monitoring of anticoagulant activity tends to be more vigilant because less is known about the appropriate dosing of anticoagulants during pregnancy.
Treatment of VTE during pregnancy and the puerperium will be reviewed here [1-6]. The epidemiology, pathogenesis, diagnosis, and prevention of VTE during pregnancy and the puerperium are discussed separately. (See "Deep vein thrombosis in pregnancy: Epidemiology, pathogenesis, and diagnosis" and "Deep vein thrombosis and pulmonary embolism in pregnancy: Prevention".)
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