Antepartum phlebothrombosis and thrombophlebitis

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1.1. Two cases of antepartum phlebothrombosis and one case of antepartum thrombophlebitis have been presented.2.2. In Case 1, phlebothrombosis of the left popliteal vein occurred at the twenty-eighth week of gestation. Possible etiological factors were hypothyroidism, venous varicosities of both legs, and venous stasis of the lower extremities due to sitting. Treatment was with 400 mg. of heparin and 800 mg. of Dicumarol without ill effect to the fetus. Embolism did not occur.3.3. In Case 2, phlebothrombosis of the right popliteal vein occurred at the thirty-ninth week of gestation. Possible etiological factors were venous varicosities of both legs and an increase in clotting mechanism of the blood due to trauma received in a fall and fracture of the coccyx. Treatment was by bilateral saphenous vein ligation. Embolism did not occur.4.4. In Case 3, bilateral saphenous thrombophlebitis occurred at the thirty-sixth week of gestation. A possible etiological factor was hypothyroidism. Treatment was with the anticoagulants post partum. Extension of the process did not occur. There have been no postphlebitic sequelae.5.5. All three cases were treated with anticoagulants post partum. None had abnormal bleeding.6.6. Phlebothrombosis of the lower extremities, when it occurs near term, with its danger of emboli broken off in labor or post partum, would seem to be treated best by bilateral saphenous vein ligation. When the process occurs several weeks from term the anticoagulants might be used when more is known of the doses causing ill effect to the fetus.7.7. Antepartum thrombophlebitis of the lower extremity is rarely associated with emboli. Until more is known of the effects of the anticoagulants on the fetus it would seem to be best treated expectantly. After delivery, extension of the process and postphlebitic sequelae may be prevented by these agents.