Venous Thromboembolism in Pregnancy: A Review of Diagnosis, Management, and Prevention

Katherine Kilkenny; William Frishman

doi:10.1097/CRD.0000000000000756

Venous Thromboembolism in Pregnancy: A Review of Diagnosis, Management, and Prevention

Cardiol Rev. 2024 Jul 25. doi: 10.1097/CRD.0000000000000756. Online ahead of print.

Authors

Katherine Kilkenny^{1

2}, William Frishman^{2

3}

Affiliations

¹ From the Department of Medicine, New York Presbyterian-Weill Cornell Medicine, New York, NY.
² Department of Medicine, New York Medical College, School of Medicine, Valhalla, NY.
³ Department of Medicine, Westchester Medical Center, Valhalla, NY.

PMID: 39051770
DOI: 10.1097/CRD.0000000000000756

Abstract

Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism, is a leading cause of maternal morbidity and mortality worldwide. Physiological changes that occur in a normal pregnancy increase the risk for VTE by 4-5-fold in the antepartum period and 30-60-fold in the immediate postpartum period. Compressive ultrasonography is the diagnostic test of choice for deep vein thrombosis. Both ventilation/perfusion scanning and computed tomography pulmonary angiography can reliably diagnose pulmonary embolism. Anticoagulation for a minimum of 3 months, typically with low molecular weight heparin, is the treatment of choice for pregnancy-associated VTE (PA-VTE). Despite the significant societal burden and potentially devastating consequences, there is a paucity of data surrounding the prevention of PA-VTE, resulting in major variations between international guidelines. This review will summarize the current recommendations for diagnosis, management, and prevention of PA-VTE.