Deep vein thrombosis (DVT) during pregnancy definitions and facts
During pregnancy, factors that increase the risk of developing DVT include varicose veins, diabetes multiple gestations, and more.
- 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 the risk of developing DVT include:
- Varicose veins
- Diabetes
- Multiple gestations
- Inflammatory bowel disease (Crohn’s disease, ulcerative colitis, UC)
- Urinary tract infection
- BMI of 30 or greater
- Over 35 years old
- Hospitalization for non-delivery reasons
- The risk for DVT increases in the postpartum period. Factors that increase the risk of developing DVT in the postpartum period include:
- Cesarean section
- Stillbirth
- High blood pressure (hypertension)
- Eclampsia or preeclampsia
- Postpartum infection
- Obstetric hemorrhage
- Preterm delivery at less than 36 weeks
- Other underlying medical conditions
- BMI (body mass index) of 25 or greater
- Over 35 years of age
- Smoking
- Anticoagulation therapy including the 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).
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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
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.
