Risk factors and prevention strategies of pregnancy-related venous thromboembolism

Abstract

Venous thromboembolism (VTE) refers to abnormal coagulation of blood in the lumen of vein vessel, which formes a thrombus and causes blood vessel to be completely or partially blocked, then leads to blood circulation disorder. Among them, deep vein thrombosis (DVT) and pulmonary embolism are common, but cerebral venous sinus thrombosis and ovarian venous thrombosis are rare in clinical practice. VTE is a kind of very serious and potentially fatal complication of pregnancy. As a special population, pregnant women themselves are risk population of VTE. If other risk factors of VTE are combined at the same time, including pre-pregnancy risk factors, obstetric risk factors and new or transient risk factors during pregnancy, the risk of VTE in pregnancy and puerperium can be increased. How to identify the risk factors of VTE and manage these risk factors are the urgent problems in obstetrics. The proportion of causes of death of VTE in pregnant women is increasing gradually in China, but there is still no guideline or expert consensus on maternal VTE management. Based on the existing research evidences of the risk factors of pregnancy-related VTE and their prevention, diagnosis and treatment guidelines and consensus expert opinion, this paper expounds the risk factors, risk classification and management strategies of pregnancy-related VTE from four aspects: the causes of VTE in pregnancy, the risk factors of pregnancy and puerperal VTE, the risk factors assessment and prevention of pregnancy-related VTE, aiming at providing practical clinical guidance on the identification of VTE risk factors and management of pregnancy-related VTE. Key words: Thrombosis; Venous thromboembolism; Thromboembolic disease in pregnancy and the puerperium; Heparin, low-molecular-weight; Management of pregnancy-related venous thromboembolism; Risk factor; Pregnant women; Puerperant