Deep vein thrombosis is a medical condition characterized by the development of blood clots in the deep veins, usually in the deep veins of the legs. It has been estimated that about 80% of deep vein thrombosis during and after pregnancy occurs in the left leg. If left untreated, deep vein thrombosis can break off, travel throughout the blood system. It will reach to the lungs leading to a serious and sometimes even a life-threatening medical condition known as pulmonary embolism. The good news is that both deep vein thrombosis and pulmonary embolism are preventable and treatable medical conditions. Women who have an increased risk of deep vein thrombosis during and after pregnancy should be closely monitored. Deep vein thrombosis and pulmonary embolism, both are commonly medically known as venous thromboembolism. It affects about one pregnant woman among every 1,000 pregnant women. However, venous thromboembolism affects 5 to 10 % more pregnant women compared to non – pregnant women at the same age. Venous thromboembolism is about 20 % more common among women after pregnancy as well. About 8 weeks after childbirth the risk of deep vein thrombosis and pulmonary embolism gets back to normal levels. Just like it was before conceiving and giving birth. Why is deep vein thrombosis more common during and after pregnancy?
Normally, during pregnancy, the levels of blood clotting proteins increase. This is as the human body increases the ability to clot the blood, necessary during childbirth in order to prevent too much bleeding. In the same time, the levels of anti-clotting proteins decrease. Other factors which have a great impact on the development of deep vein thrombosis during and after pregnancy include enlarged uterus. It increases the pressure on the pelvic veins affecting this way the normal blood return from the lower part of the body to the heart. Not every pregnant women or woman who recently gave birth will develop deep vein thrombosis. Certain factors increase the risk of deep vein thrombosis and pulmonary embolism during pregnancy and in the first few weeks after delivery. Risk factors include: • Being older than 35 years old, • Being overweight and especially obese, • Having a personal or family history of deep vein thrombosis and pulmonary embolism, • Having hypertension, • Having various vascular diseases, • Having inflammatory bowel disease, • Developing preeclampsia during pregnancy, • Having severe varicose veins, • Being on bed rest due to having a high - risk pregnancy, • Taking birth control pills, • Giving birth by Cesarean delivery (C-section), • Smoking, etc. Signs and symptoms of deep vein thrombosis Common signs and symptoms of deep vein thrombosis include: • Pain and a feeling of tenderness affecting just one leg, usually the left leg, • Tenderness and a warm sensation in the calf and sometimes even in the thigh, • Swelling of the affected leg which can be mild, moderate and even severe, etc. In cases when the blood clot from the lower extremities breaks off and travels through the circulatory system reaching the lungs, the following signs and symptoms are possible: • Sudden chest pain which can be mild, moderate or severe, • Sudden and unexplained shortness of breath, • Rapid heartbeat, • Increased breathing rate, • Coughing up blood, etc. How to prevent deep vein thrombosis during and after pregnancy? If you previously had problems with deep vein thrombosis you should take action. If a close relative had problems with deep vein thrombosis you should let your healthcare practitioner know. This is so that he/she can take extra precautions and closely monitor your pregnancy during the entire nine months. This includes your health condition in the first 8 weeks after childbirth. If you notice any of the above – mentioned signs and symptoms during pregnancy or in the first weeks after childbirth you should seek immediate medical help. In cases when a blood clot is diagnosed, you will be treated with heparin. This is a blood thinning medication during pregnancy and in the first two months following childbirth in order to prevent further clotting of the blood. However, once labor begins your healthcare provider will need to change your medications in order for you not to excessively bleed during childbirth. As mentioned, blood clots during and after pregnancy can be successfully prevented. Here are some tips on how to prevent deep vein thrombosis while carrying a child: • Exercise regularly as long as it is safe for you to exercise and you are not having a high – risk pregnancy, • Stretch constantly every 2 to 3 hours, • Walk a lot, • If you have an increased risk for deep vein thrombosis wear supportive socks and hose which will prevent deep vein thrombosis from developing, • Use heparin as recommended by your doctor regularly if needed, etc.
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October 2017
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