Deep vein thrombosis in pregnant women should be treated more aggressively, research suggests

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Pregnant women who develop iliofemoral deep vein thrombosis often forgo the most effective treatment for fear of harming the baby. Yet treatment to remove the clot is not only safe, it can prevent serious problems, and death, suggests research presented at the International Symposium on Endovascular Therapy (ISET), 19–23 January 2013, Miami, Flordia, USA.

Iliofemoral deep vein thrombosis is four to six times more common in pregnant women than those who are not pregnant. If deep vein thrombosis is not treated early and effectively, the clot can become permanent, causing lifelong pain and blood flow problems in the leg. The most effective treatments include the minimally invasive delivery of clot-dissolving drugs directly to the clots to dissolve them, or surgery to remove them, according to the presentation.

The study included 11 pregnant women with deep vein thrombosis; nine were treated with minimally invasive techniques by guiding a catheter into the clot to deliver clot-dissolving drugs, and two had surgery to remove the clot. Treatment successfully eliminated the clot in all cases. 10 of the pregnancies resulted in a successful birth. One woman in her second trimester miscarried a week after treatment. The woman suffered from antiphospholipid antibody syndrome, which causes the blood to clot abnormally and increases the risk of miscarriage, so the underlying condition likely was the cause of her miscarriage, researchers said. Three of the women had successful subsequent pregnancies.

Pregnant women who develop deep vein thrombosis typically are treated less aggressively with blood thinners, which rarely clears the clot, researchers added.

“Pulmonary embolism is the leading cause of maternal death in North America,” said Anthony Comerota, director of the Jobst Vascular Institute at The Toledo Hospital, Ohio, USA. “Physicians should use more effective treatment to prevent these women from having serious life-long problems that can affect their ability to function normally.”