ABSTRACT
Introduction 292 Epidemiology 292 Pathogenesis 295 Diagnosis of venous thromboembolism during pregnancy 300 Treatment of venous thromboembolism during pregnancy 303
The postthrombotic syndrome and pregnancy-related deep vein thrombosis 307
Cerebral venous sinus thrombosis 307 Conclusions and future directions 307 References 308
Venous thromboembolism (VTE), consisting of deep vein thrombosis (DVT) and pulmonary embolism (PE), is a potentially fatal disease with an estimated annual incidence of 0.1 percent in Caucasian populations.1 Long-term sequelae, in particular postphlebitic syndrome (PPS), are frequent and can be disabling. Pregnancy has long been recognized as a risk factor for VTE, with the importance of this relation underlined by the fact that at the end of the twenty-first century, PE remains a leading cause of maternal mortality in developed countries. This chapter covers several aspects of pregnancy-related VTE including epidemiology, etiology, and the unique challenges in diagnosis and management presented by both changes in maternal physiology and the need to include an assessment of fetal risk in any decisionmaking process.
