ABSTRACT
Deep venous thrombosis (DVT) and pulmonary embolism are leading causes of maternal mortality during pregnancy and the puerperium in the developed world. Early recognition, diagnosis and treatment of thromboembolism reduce morbidity and mortality. From 1952, the Confidential Enquiries into Maternal Deaths have provided comprehensive data on mortality from thromboembolic events. Advanced maternal age and operative delivery are major risk factors for the development of DVT. The incidence of clinically diagnosed DVT is estimated to be 0.08–1.2% following vaginal delivery, increasing to 2.2–3.0% after Caesarean section. Antithrombin III deficiency is the most thrombogenic, but is uncommon, and the associated risk of thromboembolism in pregnant women who are not receiving anticoagulant treatment is about 30%. D-dimer, which is a breakdown product of fibrin, is used as a screening test for venous thromboembolism in the non-pregnant state, as it has a high negative predictive value. The specific therapy of choice in pregnant women presenting with venous thromboembolism is anticoagulation.
