ABSTRACT
Pregnancy, and especially the post-partum state, are risk factors for venous thrombosis and pulmonary embolism. The incidence of deep vein thrombosis (DVT) during pregnancy may be as high as one in 200 deliveries and is higher post-partum. Women undergoing Caesarean section are up to 16 times more likely to develop a DVT than those delivered vaginally. Pulmonary embolism is relatively less common, affecting one in 2000 pregnancies, but it remains one of the most common causes of maternal death. The management of anticoagulation during pregnancy presents some particularly challenging problems. Central nervous system defects, possibly the result of haemorrhage and scarring and subsequent impaired brain tissue growth, may develop following exposure to warfarin during any stage of pregnancy. Heparin is the anticoagulant of choice in pregnancy as it does not cross the placenta. The use of thrombolytic therapy during pregnancy is an extremely difficult issue requiring specialist advice.
