Incidence and characteristics of venous thromboembolic disease during pregnancy and the postnatal period: a contemporary series.

摘要: Background To evaluate the incidence and characteristics of venous thromboembolic events (VTE) associated with pregnancy in a contemporary patient series. Methods We performed retrospective review 33,311 deliveries between June 2003 2008. Patients objective documentation VTE during or 3-month postnatal period were identified from hospital discharge International Classification Disease Codes edition 9 codes. Diagnosis deep thrombosis (DVT) was largely made by Duplex ultrasound, whereas pulmonary embolism (PE) diagnosed computerized tomographic angiography (CTA). Results Of study period, 74 patients (0.22%) had VTE. There 40 incidents DVT (0.12%) 37 PE (0.11%). involved iliac veins (6), femoral popliteal (16), infrapopliteal (17), axillary vein (1). Most (57.5%) DVTs left lower extremity. Thirty-eight (51.6%) VTEs occurred those 33 (87%) within 1 week delivery. (68%) seen who underwent cesarean section. Among pregnancy, there 28% first trimester, 25% second, 47% third. Events distributed among maternal age groups as follows: 26% aged 13-24, 50% 25-34, 24% 35-54. 35 tested for hypercoagulable disorder, 12 found to have positive test result. Five (6.8%) these prior history VTE, two having disorder. In addition, 45 on oral contraceptive therapy received hormonal stimulation before pregnancy. treated low molecular weight unfractionated heparin. subcutaneous heparin coumadin. Six inferior vena cava filters placed bleeding complications result anticoagulation. no deaths period. Conclusions Comparing our results historic controls (DVT: 0.04-0.14% PE: 0.003-0.04%), has not changed significantly. note, however, that embolus series is higher than previously reported. CTA been used diagnosis since past decade. The increase rate current may be because sensitivity when compared previous diagnostic modalities.